The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts

COMPARISON OF ALBUTEROL DELIVERY USING TWO DIFFERENT NEBULIZER POSITIONS DURING HIGH FREQUENCY OSCILLATION AND CONTINUOUS POSITIVE EXPIRATORY PRESSURE IN A SPONTANEOUS BREATHING ADULT LUNG MODEL.

Robert J. Harwood1, Arzu Ari1, Hui-Ling Lin2, Lynda Goodfellow1, James Fink1; 1Respiratory Therapy, Georgia State University, Atlanta, GA; 2Respiratory Therapy, Chang Gung University, Tao-Yuan, Taiwan

BACKGROUND: Continuous high frequency oscillation (CHFO) and continuous positive expiratory pressure (CPEP) is used for atelectasis and retained secretions but may compromise aerosol delivery. MetaNeb device (Hill-Rom) with CPEP and CHFO with low and high oscillation has an integrated jet nebulizer (Salter) to administer aerosol. Our goal was to quantify aerosol delivery using nebulizer with CPEP and CHFO (low and high frequency) at two different nebulizer positions and compare to standard nebulizer alone. METHOD: An upper airway teaching mannequin was connected at the bronchi with absolute filter (Respirgard II) to one chamber of a test lung (Michigan Instruments) while the other chamber was ventilated to simulate spontaneous breathing at respiratory rate 15 bpm, inspiratory flow rate 30 L/min, I:E ratio 1:1.3. Albuterol (2.5 mg/3 mL) was nebulized with nebulizer alone, and with CPEP and CHFO (high and low frequency) with nebulizer integrated in the manifold (as designed) and placed between manifold and mouthpiece (optional position) (n=3). Drug was eluted from the filter and analyzed using spectrophotometry (276 nm). ANOVA and paired t-test were performed (p ≤ 0.05). RESULTS: The table shows the mean inhaled (±SD) % of albuterol delivered distal to the trachea. In the integrated position, aerosol delivery was less than 0.42% in all modes. The optional nebulizer position increased delivery compared to integrated nebulizer position in CHFO with low and high frequency as well as CPEP (p=0.017, p=0.013 and p=0.006 respectively) but was less than nebulizer with mouthpiece (p=0.0001). Nebulizer with mouthpiece was more efficient than any condition tested with CHFO and CPEP (p=0.0002).CONCLUSION: Placement of nebulizer between manifold and mouthpiece (optional position) increased aerosol delivery efficiency by an order of magnitude during CHFO and CPEP. Sponsored Research - None