The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts


Maher M. AlQuaimi1, James Fink1,2, Robert Harwood1, Arzu Ari1; 1Respiratory Therapy Department, Georgia State University, Atlanta, GA; 2Aerogen,Ltd, San Mateo, CA

BACKGROUND: Although patients with acute increase in airflow resistance may require aerosol therapy and noninvasive positive pressure ventilation (NIPPV), the efficiency of different aerosol devices during NIPPV is not well understood. The purpose of this study was to determine the efficiency of jet nebulizer (JN), vibrating mesh nebulizer (VMN) and pressurized metered-dose inhaler (pMDI) during NIPPV. METHOD: An in-vitro lung model consisted of the upper airway of an adult teaching manikin with a collecting filter at the level of the bronchi attached to a passive test lung. NIPPV was administed via full face mask with PIP/PEEP of 20/5 cmH2O. Aerosol generators were placed between the leak and the mask. Albuterol sulfate (2.5 mg/ 3ml) was nebulized with the JN (Micromist), and VMN (Aeroneb Solo).Four puffs (108 µg/puff) administered with pMDI (ProAir HFA) and spacer (Aerovent) that is placed in the recommended Normal position (pMDI-N) with aerosol plume directed towards patient, and Reversed position (pMDI-R) with aerosol directed away from patient (n=3). Filters were eluted with 0.1 HCl and analyzed by spectrophotometer at 276 nm. Residual volume was determined gravimetrically. Descriptive statistics, repeated measures ANOVA and independent t test were used (p < 0.05). RESULTS: The mean (± SD) values for inhaled mass, percentage of dose inhaled and residual volumes are shown in the table below. During NIPPV inhaled mass and inhaled mass percent were very significant (p=0.042 and p=0.028, respectively). Aerosol delivery with JN was lowest during NIPPV. VMN has a significantly lower residual volume than JN (p=0.0001). Efficiency of pMDI was not significantly different at both orientations (p=0.253). CONCLUSION: The type of aerosol device used during NIPPV influence aerosol delivery in this simulated adult lung model. The JN is less efficient than VMN and pMDI in either orientation. Sponsored Research – None