2012 OPEN FORUM Abstracts
IN-VITRO COMPARISON OF AEROSOL DRUG DELIVERY IN PEDIATRICS USING PRESSURIZED METERED DOSE INHALER, JET NEBULIZER, AND VIBRATING MESH NEBULIZER WITH AMBU BAG.
Huriah A. Al Sultan, James B. Fink, Robert Harwood, Meryl Sheard, Lawrence Bryant, Arzu Ari; Respiratory Therapy, Georgia State University, Atlanta, GA
Background: While some studies compare jet nebulizer (JN), vibrating mesh nebulizer (VMN) and pMDI, there is no study comparing these three devices in young children with self-inflating resuscitator. The aim of this study was to quantify aerosol in a simulated pediatric with active and passive breathing patterns. Methods: Albuterol was administered with JN (Misty-neb) and VMN (Aeroneb Solo) with 2.5 mg in 3 mL NS, and via pMDI (ProAir HFA) 108 µg per puff and total of 4 puffs with valved holding chamber (AeroChamber). Each aerosol generator was placed between self-inflating bag (Ambu Inc) and infant facemask (Mercury Medical), held firmly against the face of a SAINT infant upper airway model. Active and passive breathing parameters (Vt of 100 mL, RR of 30 breaths/min, and I:E ratio of 1:1.4 ). Active breathing was simulated using a ventilator (Esprit, Respironics/Philips Healthcare) connected to a dual chamber test lung (Michigan Instruments), attached to an absolute filter (Respirgard II), connected to the SAINT model. Ambu bag was run at 10 L/min of oxygen and attached to aerosol generator with facemask. Passive breathing consisted of manual ventilation of the SAINT to a passive test lung. Each aerosol device was tested three times (n=3) with each breathing pattern. Drug was eluted from the filter and quantified using spectrophotometry (276 nm). One-way analysis of variance (one-way ANOVA) and independent t-test were performed (p < 0.05). Results: Table shows tracheal deposition of albuterol mass and % of dose (mean ±SD). Deposition with the JN was similar with active and passive, while pMDI and VMN were more efficient in active breathing. pMDI/VHC had greater deposition % (p=0.013) while VMN delivered greater drug mass . Conclusion: Aerosol treatment may be administered to young children using JN, VMN, or pMDI/VHC combined with ambu bag. Active breathing is more efficient with VMN and pMDI/VHC. Sponsored Research - None Tracheal deposition of albuterol mass and % of dose (mean ±SD)