Document Detail


Influences of cannula size and flow rate on aerosol drug delivery through the Vapotherm humidified high-flow nasal cannula system.
MedLine Citation:
PMID:  23628834     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We investigated the in vitro inspired dose and particle size distribution of albuterol delivered by a vibrating mesh nebulizer through the Vapotherm (Stevensville, MD) humidified high-flow nasal cannula system.
DESIGN: Albuterol (2.5 mg/3 mL) was delivered by an Aeroneb Solo (Aerogen, Galway, Ireland) nebulizer that was connected via adaptor proximal to the nasal cannula and downstream from the Vapotherm 2000i. Albuterol was collected onto an inspiratory filter mounted to a breath simulator programmed with age-appropriate breathing patterns. Particle sizing was completed by cascade impaction. Albuterol was quantified using ultraviolet spectrometry. Measurements were made using varying flow rates through infant, pediatric, and adult nasal cannulae.
SETTING: Aerosol research laboratory.
MEASUREMENTS AND MAIN RESULTS: The inspired dose (percent of nominal dose) for each cannula size and flow rate was 2.5%, 0.8%, 0.4%, and 0.2% for the adult cannula at 5, 10, 20, and 40 L/min, respectively; 1.2%, 0.6%, 0.1%, and 0.0% for the pediatric cannula at 3, 5, 10, and 20 L/min, respectively; and 0.6%, 0.6%, and 0.5% for the infant cannula at 3, 5, and 8 L/min, respectively. Most (62-80%) of the loaded albuterol dose accumulated within the adaptor. For each cannula size, there was a significant decrease in the inspired dose with increasing flow rates, p = 0.026 (infant), p = 0.001 (pediatric), and p < 0.001(adult). The inspired dose increased with increasing cannula size for 5, 10, and 20 L/min (p = 0.007, p < 0.001, and p = 0.005, respectively). The mass median aerodynamic diameter for all trials was less than 5 µm.
CONCLUSION: The amount of albuterol delivered with the Vapotherm system using this model was lower than the amount expected for a clinical response for the majority of flow rates and cannula size combinations. Further studies are needed before routine use of aerosolized albuterol through a Vapotherm high-flow system can be recommended.
Authors:
Sarah A Perry; Kenneth C Kesser; David E Geller; Dawn M Selhorst; John K Rendle; James H Hertzog
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies     Volume:  14     ISSN:  1529-7535     ISO Abbreviation:  Pediatr Crit Care Med     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-07-22     Completed Date:  2014-03-14     Revised Date:  2014-03-19    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e250-6     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Aerosols
Albuterol / administration & dosage*
Bronchodilator Agents / administration & dosage*
Catheterization / instrumentation*
Drug Delivery Systems / instrumentation*
Nebulizers and Vaporizers*
Particle Size
Spectrum Analysis
Chemical
Reg. No./Substance:
0/Aerosols; 0/Bronchodilator Agents; QF8SVZ843E/Albuterol
Comments/Corrections
Comment In:
Pediatr Crit Care Med. 2014 Feb;15(2):186-7   [PMID:  24492196 ]
Pediatr Crit Care Med. 2014 Feb;15(2):185-6   [PMID:  24492195 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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