{"title":"Aerosol Delivery to an Adult Model via High-Flow Nasal Cannula with Inspiration-Synchronized Small-Particle Vibrating Mesh Nebulizer.","authors":"Jie Li, Osama Alanazi, James B Fink","doi":"10.1089/jamp.2025.0005","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Background:</i></b> Aerosol delivery via high-flow nasal cannula (HFNC) with an inspiration-synchronized vibrating mesh nebulizer (VMN) yielded higher inhaled doses than with a continuous VMN. Recently, a prototype VMN generating aerosol particles <3 µm improved aerosol delivery during invasive ventilation in adult and pediatric models, outperforming the conventional VMN. However, the effects of inspiration-synchronized small-particle VMN during HFNC remain unknown. <b><i>Methods:</i></b> An adult manikin was connected to a dual-chamber lung model driven by a ventilator to simulate spontaneous breathing. An HFNC system was utilized with gas flows at 15, 30, and 60 L/min with temperature at 37°C. Both small-particle and conventional VMNs were tested in inspiration-synchronized and continuous modes, with placements at the humidifier inlet and near the nasal cannula. Each experiment involved delivering 1 mL of albuterol (2.5 mg/mL) and was repeated five times. A collecting filter placed at the trachea captured aerosol, which was then eluted and assayed with UV spectrophotometry (276 nm). <b><i>Results:</i></b> When VMN was placed near the nasal cannula, inspiration-synchronized VMN consistently delivered greater inhaled doses compared with continuous VMN, regardless of aerosol particle sizes or HFNC flows (all <i>p</i> < 0.05). When positioned at the humidifier inlet, continuous VMN yielded higher inhaled doses than inspiration-synchronized VMN at 30 and 60 L/min but lower inhaled doses at 15 L/min (all <i>p</i> < 0.05). In the inspiration-synchronized mode, the small-particle VMN delivered greater inhaled doses at HFNC flows of 15 and 30 L/min than the conventional VMN, independent of nebulizer placements (all <i>p</i> < 0.05). The highest inhaled dose was observed with the inspiration-synchronized VMN placed near the nasal cannula and the continuous VMN placed at the humidifier inlet. <b><i>Conclusions:</i></b> In a model of adult transnasal aerosol delivery, the inspiration-synchronized VMN delivered a higher inhaled dose than the continuous VMN when placed near the nasal cannula. The small-particle VMN offers potential for further improvement in aerosol delivery.</p>","PeriodicalId":14940,"journal":{"name":"Journal of Aerosol Medicine and Pulmonary Drug Delivery","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Aerosol Medicine and Pulmonary Drug Delivery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/jamp.2025.0005","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Aerosol delivery via high-flow nasal cannula (HFNC) with an inspiration-synchronized vibrating mesh nebulizer (VMN) yielded higher inhaled doses than with a continuous VMN. Recently, a prototype VMN generating aerosol particles <3 µm improved aerosol delivery during invasive ventilation in adult and pediatric models, outperforming the conventional VMN. However, the effects of inspiration-synchronized small-particle VMN during HFNC remain unknown. Methods: An adult manikin was connected to a dual-chamber lung model driven by a ventilator to simulate spontaneous breathing. An HFNC system was utilized with gas flows at 15, 30, and 60 L/min with temperature at 37°C. Both small-particle and conventional VMNs were tested in inspiration-synchronized and continuous modes, with placements at the humidifier inlet and near the nasal cannula. Each experiment involved delivering 1 mL of albuterol (2.5 mg/mL) and was repeated five times. A collecting filter placed at the trachea captured aerosol, which was then eluted and assayed with UV spectrophotometry (276 nm). Results: When VMN was placed near the nasal cannula, inspiration-synchronized VMN consistently delivered greater inhaled doses compared with continuous VMN, regardless of aerosol particle sizes or HFNC flows (all p < 0.05). When positioned at the humidifier inlet, continuous VMN yielded higher inhaled doses than inspiration-synchronized VMN at 30 and 60 L/min but lower inhaled doses at 15 L/min (all p < 0.05). In the inspiration-synchronized mode, the small-particle VMN delivered greater inhaled doses at HFNC flows of 15 and 30 L/min than the conventional VMN, independent of nebulizer placements (all p < 0.05). The highest inhaled dose was observed with the inspiration-synchronized VMN placed near the nasal cannula and the continuous VMN placed at the humidifier inlet. Conclusions: In a model of adult transnasal aerosol delivery, the inspiration-synchronized VMN delivered a higher inhaled dose than the continuous VMN when placed near the nasal cannula. The small-particle VMN offers potential for further improvement in aerosol delivery.
期刊介绍:
Journal of Aerosol Medicine and Pulmonary Drug Delivery is the only peer-reviewed journal delivering innovative, authoritative coverage of the health effects of inhaled aerosols and delivery of drugs through the pulmonary system. The Journal is a forum for leading experts, addressing novel topics such as aerosolized chemotherapy, aerosolized vaccines, methods to determine toxicities, and delivery of aerosolized drugs in the intubated patient.
Journal of Aerosol Medicine and Pulmonary Drug Delivery coverage includes:
Pulmonary drug delivery
Airway reactivity and asthma treatment
Inhalation of particles and gases in the respiratory tract
Toxic effects of inhaled agents
Aerosols as tools for studying basic physiologic phenomena.