2010 OPEN FORUM Abstracts
AN APPROACH TO DELIVERING AEROSOLIZED MEDICATION WITH HIGH FREQUENCY JET VENTILATION.
Jeffrey Wright, Kevin Crezee; Respiratory Care, Primary Childrens Medical Center, Salt Lake City, UT
Background: The purpose of this study was to determine if aerosolized Albuterol could be delivered in conjunction with the Bunnell High Frequency Jet Ventilator (HFJV), and what ventilation effects could be seen with the approach. Method: The ventilators are set with the following settings; HFJV: Rate 420, PIP 20, PEEP 5 cmH2O, temperature cartridge at 38 C and the circuit at 40 C. Bird VIP: PEEP 5 cmH2O, Flow 8 LPM, no rate, temperature chamber at 35 C and the circuit at 37 C. The approach is to side stream the endotracheal tube (ETT) 2 cm distal to the Bunnell Life Port with tees that are the same inner diameter (ID) as the ETT. The tee is connected to the ETT that has been attached to the neonatal lung model. An Aerogen Aeroneb Pro Solo with Pediatric Tee adaptor is adapted to connect as aside stream to the ETT tee. A gas source is connected to distal end of the Aerogen tee adaptor. The 3 ETT sizes chosen coincided with the Life Port sizes. To measure the aerosol deposition a pre weighed disposable paper filter was placed between the end of the ETT and before the lung model. The filters were weighed again once the aerosolized Albuterol (3 ml unit dose) was complete. Controls were performed to determine background humidity (see table 2). Results: Gas flows used for testing: No Flow, 0.25 LPM, and 0.5 LPM. The ventilators were allowed to reach a steady state. Flow testing: The pressures within the lung model were recorded. Flow was then added at the ETT tee and changes in pressure were noted (see table 1 results). Deposition testing: Each ETT size was subjected to 5 runs of aerosol with each of the flow options and depositions were recorded (see tables 3, 4, and 5 results). Conclusions: Aerosolized medication using a side steam of the ETT is possible. The depositions amounts vary widely depending upon flow and ETT size. Higher flow rates were shown to have higher deposition values of medication with all the ETT sizes. The 0.5 LPM appears to be the best option, though the pressure changes in the lung model may be construed as an impairment of ventilation. Further testing should be completed. Animal testing that include; arterial blood gasses pre and post aerosolized albuterol using the method as described to determine ventilator effects, and aerosolized radionuclides may provide definitive data on aerosol deposition and distribution. Sponsored Research - None