The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts


John Davies, Lee Williford, Renee Bartle, Randy Stallings, Robert Pagnanelli, Neil MacIntyre; Duke Medical Center, Durham, NC

BACKGROUND: Aerosol delivery during high frequency ventilation (HFV) has been sparsely studied. To address this, we assessed aerosol delivery during HFV using two aerosol devices - a vibrating mesh (VM)) and a prototype aerosol generating catheter (AGC). METHODS: Twenty two ex-vivo pig lungs were intubated and attached to: 1) a conventional ventilator (CV) (CareFusion, Yorba Linda, CA) (10 lungs); 2) A high frequency oscillator (HFO) (CareFusion, Yorba Linda, CA) (6 lungs); or 3) A high frequency jet ventilator (HFJV) (Bunnell, Salt Lake City, UT) (6 lungs). During CV and HFO, half of the aerosols were delivered with the VM (Aerogen, Galway, Ireland) and half were delivered with the AGC (Trudell Medical International, London, Canada). With HFJV, the VM was used in 2 lungs with the device placed in the circuit near the ventilator (Draeger Medical Inc., Telford, PA) and in 2 lungs with the device placed in the jet interrupter system. The AGC was used in 2 lungs during HFJV. Deposition was assessed by aerosolizing 10 millicuries of technetium-labeled DTPA followed by a 3 minute scan. Regions of interest were then drawn around the device/circuitry, the central airways, and lung parenchyma. Percent of total dose was calculated for each and paired t tests were used to compare deposition. RESULTS: See Table: CONCLUSIONS: With CV, central airways deposition was high with both devices but significantly higher with the AGC. Conversely, parenchymal deposition with CV was low with both devices but significantly higher with the VM. With HFO, parenchymal deposition was low with both devices while central airway deposition was quite high, especially with the AGC. During HFJV, the VM placed in the CV circuit produced virtually no central airway or lung parenchyma deposition. Placing the VM in the jet interrupter system greatly increased central airway delivery although parenchymal delivery remained very low. The AGC had similar parenchymal deposition but nominally higher central airway delivery than the VM with HFJV.
Sponsored Research - Trudell Medical International
TABLE (mean % +/- SD)