The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts


Khaled A. Alqahtani, Timothy Op’t Holt; Cardiorespiratory Care, University of South Alabama, Mobile, AL

BACKGROUND: Respiratory therapists have adapted the small volume nebulizer (SVN) to the side hole of the air entrainment mask (AEM) to give an aerosol treatment to patients on an FiO2 > 0.4. OBJECTIVE: To evaluate the aerosol deposition of this method and to investigate available options to deliver an aerosol treatment to patients on > 40% oxygen. METHODS: In an in vitro study we compared the aerosol delivery of four techniques. Technique one adapts the nebulizer T-piece to the side hole of the AEM. Technique two adapts the nebulizer T-piece to the corrugated tube attached to the AEM. The FiO2 for the first and second techniques was set at 0.4. Technique three used a standard aerosol face mask and SVN. Technique four used a simple face mask with two valves, connected to a reservoir bag and nebulizer by a wye connector, run at 15 L O2/min. Three mL of saline was nebulized in the SVN for eight minutes in each of 5 trials per technique. An airway manikin’s trachea was connected to a lung simulator that simulated a spontaneously breathing adult (f=20, VT = 500 mL). Aerosol delivery was assessed by the residual gravimetric method by collecting the aerosol on a dry inhalation filter that was attached between the end of the manikin’s trachea and test lung. One-way ANOVA and Tukey’sHSD were used to analyze the data. P < 0.05 was considered significant. RESULTS: The mean ± SD weight change of the inhalation filter values for the four techniques, respectively, were 24.84±23.44 mg, 6.66±1.83 mg, 189.42±39.25 mg and 6±1.72 mg. There were significant differences in filter weight change between technique 3 and the first, second, and fourth techniques. Deposition of saline in techniques 1, 2, and 4 were, respectively, 0.82%, 0.22%, and 0.2%. The deposition in technique 3 was 6.31%. Deposition using technique 3 was similar to what the literature showed as an effective deposition percent. CONCLUSION: Aerosol delivery was significantly less when techniques 1,2, and 4 were used to deliver an aerosol treatment. The third technique had significantly higher aerosol delivery to the inhalation filter than the other techniques. Thus, those three techniques should not be used to deliver an aerosol treatment because the percent aerosol delivered was < 1%. Sponsored Research - None