1999 OPEN FORUM Abstracts

DOES ELECTRO-STATIC CHARGE OF THE MATERIALS IN ENDOTRACHEAL TUBES REDUCE DELIVERY OF AEROSOL DURING MECHANICAL VENTILATION?

J B Fink, MS, RRT, K.E Fahey, R. Dhand, MD. Div of Pulm and Crit Care Med, Hines VA Hospital, Loyola Stritch School of Med, Hines, IL.

Background: Electrostatic charge of some plastics has been shown to reduce aerosol delivery from metered-dose inhalers through spacer devices. The effects of these electrostatic charges were reduced with application of de-ionizing soap solutions such a common dish soap.

Methods: To determine if the electrostatic charge in endotracheal tubes reduces aerosol delivery, four puffs of albuterol (360mg) were administered from a MDI into an integrated heated-wire circuit with spacer/actuator (Fisher Paykel) during CMV (VT 800 ml, peak flow 40 L/min, rate 12/min), under heated/humidified conditions, through 8.0 mm ID endotracheal tubes (Sheridan and Allegiance, n=4) when each tube was: 1) fresh from the package; 2) rinsed with tap water; and 3) washed with de-ionizing soap (Joy). Delivery of albuterol (% of nominal dose SE) to the distal tip of the endotracheal tube was determined.

Results: Aerosol delivery through the endotracheal tube from the package (28.91.6%) and after rinsing with tap water (29.50.35%) were similar. Washing the endotracheal tube with de-ionizing soap resulted in improved aerosol delivery (34.60.46%; p<0.02).

Discussion: Use of a de-ionizing soap (shown to reduce electrostatic charge) significantly improved aerosol delivery in both brands of endotracheal tube tested. Materials with less electrostatic charge in endotracheal tubes may improve aerosol delivery.

Conclusion: Washing endotracheal tubes with de-ionizing dish soap improves aerosol delivery of albuterol from a MDI during mechanical ventilation.

OF-99-176