The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts

A COMPARISON OF METERED DOSE INHALER DRUG DELIVERY AND PLACEMENT WITH AND WITHOUT THE NEOFLOW™ SENSOR.

Lisa Tyler1, Leane Soorikian1, Linda Allen-Napoli1, James Fink2, Richard Lin1; 1Respiratory Care, The Children’s Hospital of Philadelphia, Philadelphia, PA; 2Georgia State Unversity, Atlanta, GA

Background: Delivery of bronchodilators via metered dose inhaler (MDI) is common in neonatal mechanically ventilated patients. Use of Neoflow™ at the airway is preferred, but impact on aerosol delivery has not been reported. Recent Ventilator Associated Pneumonia initiatives promote maintaining circuit integrity even during delivery of inhaled medications. Removal of the Neoflow™ sensor to deliver MDI to this patient population may lead to increased risk of VAP and safety risks related to ventilator setting augmentations. Method: Using a Dräger Evita XL set in PC 20/5 x 30 x 21%, 8 puffs (720mcg) of albuterol was delivered via MDI spacer (Airlife Dual Minispacer™) placed in the inspiratory limb of a neonatal heated wire circuit (37 ± 1 ° C) both distal (6 inches) and proximal to the wye with and without the Neoflow™ sensor. Drug was collected on a nonconductive respiratory filter distal to a 3.5 mm ETT and attached to a passive test lung. The same circuit was used for all trials (n=3); they were performed in the order listed. Samples were eluted from the filters using an ethanol/water mixture. Absorbance at 276 nm was used to estimate the amount of albuterol in the eluent. Results: See table below Conclusion: No trend was found on deposition with the Neoflow™ sensor present or absent from the circuit, and no difference between distal or proximal position. Further studies are needed to standardize delivery method and quantify dose delivered with and without Neoflow.™ Sponsored Research - None Table shows results of each run with ug of albuterol also expressed as mean ± SD.