1998 OPEN FORUM Abstracts
AN EVALUATION OF AEROSOLIZED ALBUTEROL DELIVERY FROM DIFFERENT LOCATIONS IN A Bi-PAP CIRCUIT
David Blakeman, AS, RRT, Eastem Idaho Regional Medical Center, Idaho Falls, ID
Introduction: An extensive literature review provided no documented evidence regarding the best location to place in line and deliver albuterol via SVN in a Bi-PAP circuit. A bench study was designed to evaluate the delivery of albuterol from two different locations in a Bi-PAP circuit.
Study Question: Does location of SVN in Bi-PAP circuit effect medication delivery?
Methods: The SVN's were placed in line in the Bi-PAP circuit at two different locations during the bench study. Location #1 was next to the whisper valve; and location #2 was next to the Bi-PAP machine. The five SVN's used were from the same lot and were pretested for comparability. Five trials for each of the two delivery locations were performed. A Respironics Bi-PAP S/T-D 30 was used for this bench study with a standard 70 inch smooth bore circuit tubing (pressures set at 10/5). The patient end of the tubing was connected to a whisper valve and connector with inlet port for Bi-PAP pressure monitoring. This was connected to the following design to simulate a spontaneously breathing patient: Tygon tubing (10 cm long, 2 cm diameter), collection chamber, 6 inches of large bore tubing which was connected to a Michigan Instruments double sided test lung with lift bar. One side of the test lung was attached to a Hamilton Veolar ventilator (Vt 700, RR 12/min, sine wave, flow 65 L/min, SIMV, PEEP 8, PEEP was added to keep the Bi-PAP from self cycling) and the other side was attached to the Bi-PAP setup. 100% cotton wadding was placed in the collection chamber. SVN's in both locations were run until sputter, tapped 6 times, run to sputter again. The extracted solution was filtered through a slow-flow filter to remove any cotton fibers or impurities. Absorbance was measured at 278 nm (spectrophotometer).
Results: Location #1 delivered 5.07% of the total dose. Location #2 delivered 3.47% of the total dose. Location #1 had a 1.6% increase over location #2. ANOVA for repeated measures revealed significant differences between the two locations (p < .01).
Conclusion: The results from this study would indicate that when delivering aerosolized medication to a patient while on a Bi-PAP system the best location for SVN placement would be next to the whisper valve or Bi-PAP mask under the conditions set in this study.
The author wishes to thank Jerry Hunt, MS, RRT, RPFT for technical assistance and support.
The 44th International Respiratory Congress Abstracts-On-Disk®, November 7 - 10, 1998, Atlanta, Georgia.