The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts


Jan Mazela1,2, Krzysztof Chmura2, Timothy J. Gregory1, Chris Henderson1; 1Preclinical, Discovery Laboratories, Inc., Warrington, PA; 2Department of Neonatology, Poznan University of Medical Sciences, Poznan, Poland

Background: Different ventilators and different modes of ventilation create different flow conditions that may influence the effectiveness of inhaled therapies delivered to neonates. A novel aerosol delivery system (Afectair® Duo, Discovery Laboratories, Inc.) incorporates a bypass circuit that diverts a portion of the inspiratory gas flow from the standard ventilator circuitry to entrain an aerosolized medication. This delivery system has been developed to facilitate aerosol delivery to ventilated neonates. Aim: The aim of the study was to test the function of this novel aerosol delivery system under different neonatal ventilatory conditions when used with ventilators that have different operational characteristics. Methods: Three different neonatal ventilators were used in this study: Babylog® VN-500 (Draeger, Luebeck, Germany), Servo-i (Maquet, Solna, Sweden), and Avea® (CareFusion, San Diego, CA). Ventilator conditions studied were PEEP=5 cmH2O, IT=0.35 s, RR=30 and five different PIP settings: 12, 16, 20, 25, 30 cmH2O delivering ventilation to an expandable test lung. A mass flow meter (TSI Series 4100) was used for flow measurements within the inspiratory arm of the circuit and at the bypass nebulizer arm. Results: All ventilators presented a similar correlation between flow at the bypass nebulizer arm and PIP (R2 = 0.7809) and tidal volume (R2 = 0.6394) [Figure 1: Relationship between tidal volume and nebulizer or peak inspiratory flows]. There were no leaks or ventilator compensation observed with any of the ventilators tested. The bypass aerosol arm flows were within the 10th and 90th percentile ranges of peak inspiratory flows for premature infants. Conclusions: This novel aerosol delivery system appears to be compatible with VN-500, Servo-i and Avea ventilators when used to provide neonatal ventilation and inspiratory flows (2.5-11.0 L/min), and potentially provides optimal aerosol flow conditions. Sponsored Research - Poznan University of Medical Sciences, Poznan, Poland provided financial support.