The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts


Arzu Ari, Robert Harwood, Meryl Sheard, James B. Fink; Division of Respiratory Therapy, Georgia State University, Atlanta, GA

BACKGROUND: Artificial airways such as tracheostomy tube (TT) and endotracheal tube (ETT) are commonly used for aerosol therapy as part of long-term airway management in critically ill patients. Since the primary focus of previous research was the ETT, there is no evidence in the literature about the delivery of inhaled medications administered with different aerosol devices in mechanically ventilated patients with TT. The purpose of this study was to quantify the efficiency of aerosol devices in a lung model of an intubated and mechanically ventilated adult with tracheostomy. METHOD: An in-vitro lung model was constructed to simulate mechanically ventilated adults with either TT (Portex) or ETT (Mallincrodt) of 8 mmID with both bronchi of the manikin connected to a Y adapter which was attached to a passive test lung through a collecting filter (Respirgard II, Vital Signs). A ventilator delivered adult breathing parameters (Vt: 450 mL, RR: 20/min, PEF; 40 L/min and I:E ratio: 1:3) to the airway. Drug on the filter was eluted and analyzed with spectrophotometry (276 nm). Descriptive statistics, paired sample t-test and independent sample t-test were used with p < 0.05 considered significant. RESULTS: Table shows the mean % (± SD) of emitted (pMDI) and nominal (SVN) dose delivered distal to the trachea with each device. Tracheal dose via TT is marginally greater with ETT using JN and pMDI (p=0.226 and p=0.106, respectively). Delivering aerosols with pMDI increased lung dose up to 3 fold compared to JN with both TT and ETT (p=0.0001 and p=0.001, respectively). CONCLUSION: Aerosol drug delivery via ETT is less than TT, while delivery efficiency of pMDI via either airway is greater than that of JN in this model of simulated mechanically ventilated adults. Sponsored Research - None