The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts

PULMONARY RADIOAEROSOL DEPOSITION USING MESH AND JET NEBULIZERS IN HEALTHY NORMALS DURING NONINVASIVE VENTILATION.

Arméle Dornelas de Andrade1, Valdecir Galindo-Filho1, Maria Eveline Ramos1, Simone Brandão2, Antônio Barbosa2, James B. Fink3; 1Physiotherapy, Universidade Federal de Pernambuco, Recife, Brazil; 2Nuclear Medicine, Hospital das Clínicas, Recife, Brazil; 3Respiratory Therapy, Ga State Univ, Atlanta, GA

Introduction: In vitro studies of aerosol delivery during noninvasive ventilation report > two fold differences in inhaled dose using jet and mesh nebulizers. Limited data is available to establish in vitro/in vivo correlations for aerosol delivery. Objectives: To analyze the distribution of aerosol into the lungs during administration using Mesh and Jet nebulizers during NIV in healthy subjects. Methods: Four healthy volunteers (2 female) with mean age of 26.5±3.1 years, weight 78.0± 12.35 kg, height 1.69±0.07 m, and BMI 26.52 ± 3.77 were administered aerosol containing DTPA-Tc99m with radioactivity of 25 miC in a total volume of 3 mL and 1 mL during bilevel positive pressure ventilation of 12 cmH2O / 5 cmH2O with a BIPAP device (Synchrony, Respironics, Murrysville, Pennsylvania, USA) via face mask (Respironics, Murrysville, Pennsylvania, USA) Radioactivity counts were performed using a gamma camera (STARCAM 3200 GE, California, USA). To quantify radiation counts in the lungs, upper airway, stomach, as well as nebulizer, circuit, inspiratory and expiratory filters, with activity in each compartment expressed as a percent of total radiation. filters, with activity in each compartment expressed as a percent of total radiation. Statistical analysis was performed using Friedman test, considering significant p < 0.05. Results: Table shows lung deposition reported as mean ± SD % of total radiation. Lung deposition with the Mesh was > 3 fold greater than JN, independent of dose volume used with the MESH. Conclusions: Administration of aerosol via Mesh nebulizer during NIV provided a higher radioaerosol deposition than jet nebulizer, supporting in vitro studies reporting > 2 fold difference in inhaled dose. These results have important implications in clinical practice when supporting patients with asthma or COPD to ensure effective pulmonary deposition of aerosol during NIV. Sponsored Research - None *p < 0.0001(MESH 3 mL vs JN 3 mL) and **p < 0.007 (MESH 1 mL vs JN 3 mL).