The Effect of Nebulizer Position on Aerosolized Epoprostenol Delivery in an Adult Lung Model
| Autor: | David L Vines, Carl A Kaplan, Meagan N Dubosky, Vanessa Quintana, Kelly Fiorino, Allison C Anderson |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Models Anatomic Pulmonary and Respiratory Medicine Ventilator circuit Hypertension Pulmonary 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine Humidifiers 03 medical and health sciences Drug Delivery Systems 0302 clinical medicine Interquartile range Administration Inhalation Tidal Volume Humans Medicine Lung Antihypertensive Agents Tidal volume Aerosolization Aerosols Syringe driver Ventilators Mechanical business.industry Nebulizers and Vaporizers General Medicine medicine.disease Epoprostenol Respiration Artificial Pulmonary hypertension Nebulizer 030228 respiratory system Anesthesia Breathing business |
| Zdroj: | Respiratory Care. 62:1387-1395 |
| ISSN: | 1943-3654 0020-1324 |
| DOI: | 10.4187/respcare.05344 |
| Popis: | BACKGROUND: Aerosolized epoprostenol is an alternative for inhaled nitric oxide in the management of pulmonary arterial hypertension and possibly acute hypoxemia. Our objective was to determine differences in drug deposition based on different nebulizer positions in the ventilator circuit, using a vibrating mesh nebulizer. METHODS: An 8.0-mm inner diameter endotracheal tube (ETT) was connected to a training test lung, compliance of 30 mL/cm H2O, with a collecting filter placed at the ETT-test lung junction. A mechanical ventilator, heated wire circuit, and pass-over humidifier were utilized. A syringe pump continuously instilled a 15,000-ng/mL epoprostenol solution at 30, 50, and 70 ng/kg/min into the vibrating mesh nebulizer at all 4 positions. Tidal volumes (VT) were set at 4, 6, and 8 mL/kg for a 70-kg patient with breathing frequencies of 25, 16, and 12 breaths/min, respectively. Epoprostenol was eluted from the filters (no. = 180) and analyzed with ultraviolet-visible spectrophotometry at 205 nm to estimate drug deposition. RESULTS: Epoprostenol deposition increased significantly (P = .02) as the dosage increased from 30 ng/kg/min (median 4,520.0 ng, interquartile range [IQR] 2,285.0–6,712.2 ng) to 50 ng/kg/min (median 6,065.0 ng, IQR 3,220.0–13,002.5 ng) and 70 ng/kg/min (median 9,890.0 ng, IQR 6,270.0–16,140.0 ng). No significant difference was found between variations in ventilator settings. No difference in deposition was found between the humidifier inlet and outlet, but these positions resulted in greater deposition compared with the inspiratory limb and between the ETT and Y-piece. CONCLUSIONS: The greatest amount of mean epoprostenol deposition resulted with the nebulizer placed at the humidifier inlet or outlet in a ventilator with bias flow. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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