Aerosol Delivery to an Adult Model via High-Flow Nasal Cannula with Inspiration-Synchronized Small-Particle Vibrating Mesh Nebulizer.

IF 2 4区 医学 Q3 RESPIRATORY SYSTEM
Jie Li, Osama Alanazi, James B Fink
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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.

雾化同步小颗粒振动网状喷雾器通过高流量鼻导管向成人模型输送气溶胶。
背景:雾化同步振动网状喷雾器(VMN)通过高流量鼻插管(HFNC)吸入的气溶胶吸入剂量高于连续的VMN。方法:将成人人体模型连接到由呼吸机驱动的双腔肺模型上,模拟自主呼吸。采用HFNC系统,气体流量分别为15、30和60 L/min,温度为37℃。在吸气同步和连续模式下测试了小颗粒和常规vmn,并将其放置在加湿器入口和鼻插管附近。每次实验均给药1 mL沙丁胺醇(2.5 mg/mL),重复5次。在气管处放置一个收集过滤器,收集气溶胶,然后用紫外分光光度法(276 nm)进行洗脱和分析。结果:当VMN放置在鼻插管附近时,无论气溶胶颗粒大小或HFNC流量如何,吸入同步VMN始终比连续VMN提供更大的吸入剂量(均p < 0.05)。当放置在加湿器入口处时,连续VMN在30和60 L/min时的吸入剂量高于吸气同步VMN,但在15 L/min时吸入剂量低于吸气同步VMN(均p < 0.05)。在吸气同步模式下,在HFNC流量为15和30 L/min时,小颗粒VMN比传统VMN提供更大的吸入剂量,与雾化器位置无关(均p < 0.05)。吸气同步的VMN放置在鼻插管附近,连续的VMN放置在加湿器入口处,吸入剂量最高。结论:在成人经鼻气溶胶输送模型中,当吸入同步VMN放置在鼻插管附近时,其吸入剂量高于连续VMN。小颗粒VMN为进一步改善气溶胶输送提供了潜力。
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来源期刊
CiteScore
6.70
自引率
2.90%
发文量
34
审稿时长
>12 weeks
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.
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