The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

AN IN VITRO COMPARISON OF HELIOX AND OXYGEN IN ALBUTEROL DELIVERY USING PEDIATRIC HIGH FLOW NASAL CANNULA

Arzu Ari1, Robert Harwood1, Meryl Sheard1, Patricia Dailey2, James B. Fink1; 1Georgia State University, Atlanta, GA; 2Baystate Medical Center, Springfield, MA

Background: Administration of aerosol via high flow nasal cannula (HFNC) has been described. Although the use of helium/oxygen mixture (heliox) in pediatrics has gained widespread support, the amount of aerosol delivery with a pediatric HFNC is not known. The objective of this study is to quantify aerosol delivery with heliox and oxygen in a model of pediatric ventilation. Method: A vibrating mesh nebulizer (Aeroneb Solo, Aerogen Inc., Ireland) was placed on the inspiratory inlet of a heated humidifier and heated wire circuit attached to a pediatric nasal cannula (Optiflow, Fisher and Paykel Healthcare Corporation, New Zealand). Pediatric breathing parameters of this study include: Vt 100 ml, frequency 20/min and Itime of 1 second. Using a vibrating mesh nebulizer was administered through a pediatric HFNC with oxygen (100%) and heliox (80/20% mixture). A total of 12 runs, 6 using oxygen and 6 using heliox were conducted at flow rates of 3 L/min and 6 L/min (n=3). A filter attached to the HFNC was used to collect aerosolized albuterol which was measured using spectrophotometry at 276 nm. Paired-samples t-test and independent-samples t-tests were conducted to compare aerosol delivery with heliox and oxygen at two different flow rates. Results: The % inhaled dose (mean± SD) is presented in the table below. Although the amount of albuterol delivery with heliox is similar to oxygen at 3 L/min, heliox increases aerosol deposition more than 2 fold at 6 L/min. Decreasing flow rate from 6 to 3 L/min increases aerosol delivery by 50% with heliox and 80% with oxygen. Conclusion: Using a pediatric HFNC, heliox at 6 L/min increased aerosol delivery by greater than 2 fold compared to oxygen. Reducing flow rate increased inhaled albuterol delivery in this model of pediatrics but decreased impact of heliox. Sponsored Research - None

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