The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts

THE EFFECT OF INTERFACES ON AEROSOL DELIVERY IN SIMULATED SPONTANEOUSLY BREATHING ADULTS WITH TRACHEOSTOMY

Alaa A. Bugis, Robert Harwood, James B. Fink, Lynda Goodfellow, Arzu Ari; Respiratory Care, Georgia State University, Atlanta, GA

BACKGROUND: The purpose of this study was to characterize aerosol delivery with tracheostomy collar (TC), Wright mask (WM), and aerosol mask (AM). The secondary purposes were to compare albuterol delivery between an opened vs. a closed fenestration hole and also to determine the effect of I:E ratio on aerosol delivery. METHOD: Albuterol (2.5 mg/3 mL) was administered to an invitro model consisting of an adult teaching mannequin upper airway with stoma intubated with a fenestrated tracheostomy tube, 8 mm (Shiley™). The cuff was deflated. A collecting filter (Respirgard 303) at the level of the bronchi was connected to a breathing simulator with parameters (VT 400 mL and RR 20/min) with I:E ratios of 2:1 and 1:2. The jet nebulizer (eValueMed) was operated with O2 at 8 L/min (n=3). The flow was discontinued at the end of nebulization. The nebulizer was attached to a tracheostomy collar (AirLife), Wright mask (Wright Solutions LLC) and aerosol mask (AirLife). Drug was analyzed by spectrophotometry (276 nm). Paired t-test and ANOVA, were performed (p < .05). RESULTS: Table shows mean (±SD). Aerosol delivery was greater with TC (with and without fenestration open) than either mask (p < .05). Closing the fenestration hole increased aerosol deposition significantly at 1:2 ratio (p=.04) Increasing I:E ratio from 1:2 to 2:1 increased aerosol delivery with tracheostomy collar-fenestration opened (p =.009), Wright mask (p =.02) and aerosol mask (p =.01). CONCLUSION: The tracheostomy collar delivered more aerosol to the bronchi than the Wright or aerosol mask. 2:1 ratio increases aerosol deposition more than 1:2. Closing the fenestration hole improves aerosol delivery. Sponsored Research - None