Ssu-Han Yang1, Tsung-Ming Yang2, Hui-Ling Lin3, Ying-Huang Tsai4, Tien-Pei Fang5, Gwo-Hwa Wan6. 1. Graduate Institute of Clinical Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Respiratory Therapy Team of Chest Department, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. 2. Department of Pulmonary and Critical Care, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan. 3. Department of Respiratory Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Respiratory Therapy, Chang Gung University of Science and Technology, Chiayi, Taiwan; Department of Respiratory Therapy, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan. 4. Department of Pulmonary and Critical Care, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan; Department of Respiratory Therapy, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan. 5. Department of Respiratory Therapy, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan. 6. Department of Respiratory Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Respiratory Therapy, Chang Gung University of Science and Technology, Chiayi, Taiwan; Department of Neurosurgery, Linkuo Chang Gung Memorial Hospital, Taoyuan, Taiwan. Electronic address: ghwan@mail.cgu.edu.tw.
Abstract
BACKGROUND: Few studies have evaluated the size distribution of inhaled and exhaled aerosolized drugs, or the effect of heated humidification on particle size and lung deposition. The present study evaluated these aspects of bronchodilator (salbutamol/ipratropium) delivery using a lung model in the absence and presence of heat and humidification. METHODS: We positioned filters to collect and measure the initial drug, inhaled drug, and exhaled drug. Particle size distribution was evaluated using an 8-stage Marple personal cascade impactor with 0.2-μm polycarbonate filters. RESULTS: A greater inhaled drug mass was delivered using a vibrating mesh nebulizer (VMN) than by using a small volume nebulizer (SVN), when heated humidifiers were not employed. When heated and humidified medical gas was used, there was no significant difference between the inhaled drug mass delivered by the VMN and that delivered by the SVN. A significantly greater mass of inhaled 1.55-μm drug particles was produced by the VMN than with the SVN, under heated and humidified conditions. However, the mass median aerodynamic diameters (MMADs) of the aerosolized drug produced by the SVN and VMN did not differ significantly under the same conditions. CONCLUSIONS: The VMN produced more fine particles of salbutamol/ipratropium, and the drug particle size clearly increased in the presence of heat and humidification.
BACKGROUND: Few studies have evaluated the size distribution of inhaled and exhaled aerosolized drugs, or the effect of heated humidification on particle size and lung deposition. The present study evaluated these aspects of bronchodilator (salbutamol/ipratropium) delivery using a lung model in the absence and presence of heat and humidification. METHODS: We positioned filters to collect and measure the initial drug, inhaled drug, and exhaled drug. Particle size distribution was evaluated using an 8-stage Marple personal cascade impactor with 0.2-μm polycarbonate filters. RESULTS: A greater inhaled drug mass was delivered using a vibrating mesh nebulizer (VMN) than by using a small volume nebulizer (SVN), when heated humidifiers were not employed. When heated and humidified medical gas was used, there was no significant difference between the inhaled drug mass delivered by the VMN and that delivered by the SVN. A significantly greater mass of inhaled 1.55-μm drug particles was produced by the VMN than with the SVN, under heated and humidified conditions. However, the mass median aerodynamic diameters (MMADs) of the aerosolized drug produced by the SVN and VMN did not differ significantly under the same conditions. CONCLUSIONS: The VMN produced more fine particles of salbutamol/ipratropium, and the drug particle size clearly increased in the presence of heat and humidification.
Authors: Jos L M L le Noble; Frank J M Terpoorten; Mary-Anne Funnekotter-van der Snoek; Norbert Foudraine Journal: Intensive Care Med Exp Date: 2022-04-25