Inhaled salbutamol dose delivered by jet nebulizer, vibrating mesh nebulizer and metered dose inhaler with spacer during invasive mechanical ventilation

ElHansy, Muhammad H.E.; Boules, Marina E.; Essawy, Assem Fouad Mohamed El; Al-Kholy, Mohamed Bakry; Abdelrahman, Maha M.; Said, Amira S. A.; Hussein, Raghda R. S.; Abdelrahim, Mohamed

doi:10.1016/j.pupt.2017.06.004

Cited by 47 publications

(42 citation statements)

References 34 publications

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“…The volume of 30-min and 24-h collection samples were measured and assayed for salbutamol using previously validated high-performance liquid chromatography. 14,15,17,21,31 Salbutamol was extracted from urine samples using solid-phase extraction with Oasis MCX cartridge (Waters Corporation, Milford, Massachusetts), with bambuterol hydrochloride added as internal standard, and then injected into the high-performance liquid chromatography system. A 5-m octadecyl-silica (ODS) (4.6 mm ϫ 250 mm, Zorbax Eclipse) C-18 high-performance liquid chromatography column with a 4 mm ϫ 3 mm C-18 (ODS) guard column (Agilent, Santa Clara, California) was used.…”

Section: With and Without Humidificationmentioning

confidence: 99%

Effects of Fill Volume and Humidification on Aerosol Delivery During Single-Limb Noninvasive Ventilation

et al. 2018

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Section: With and Without Humidificationmentioning

confidence: 99%

Effects of Fill Volume and Humidification on Aerosol Delivery During Single-Limb Noninvasive Ventilation

et al. 2018

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“…The choice of inhaled salbutamol dosage was in accordance with previous literature. 16,18,[24][25][26][27][28][29][30][31][32][33][34][35][36] As recommended previously in studies that used single-limb NIV, 10,30 the nebulizers were placed proximal to the subject and distal to the fixed expiratory valve, as shown in Figure 1.…”

Section: Study Protocolmentioning

confidence: 99%

Performance of Large Spacer Versus Nebulizer T-Piece in Single-Limb Noninvasive Ventilation

et al. 2018

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The T-piece and large spacer were equally efficient for salbutamol delivery from the mesh nebulizer in patients with COPD and on single-limb noninvasive ventilation. Adding a preliminary bronchodilator dose by pMDI prenebulization showed a trend toward greater pulmonary bioavailability of nebulized salbutamol and may be worth considering to maximize delivery of salbutamol to patients who are severely ill.

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“…The findings will help in developing policy and best practice for risk mitigation from fugitive emissions.Aerosol generation technologies deliver drugs to the lungs of neonatal, paediatric and adult patients through a variety of patient interfaces. Several factors influence aerosol drug delivery to the lungs, including the aerosol-generating device, the size distribution of the inhaled aerosol, the gas-flow rate, the inhalation pattern and the type of interface [5][6][7][8][9].Dysart et al [10] reported that the use of high-flow nasal therapy (HFNT) devices is rapidly growing in the clinical setting, for different age groups with a range of disease conditions. High-flow nasal therapy studies have reported gas-flow rates of 3 to 20 L/min for paediatrics, and 5 to 60 L/min for adults [11][12][13][14].…”

mentioning

confidence: 99%

“…Aerosol generation technologies deliver drugs to the lungs of neonatal, paediatric and adult patients through a variety of patient interfaces. Several factors influence aerosol drug delivery to the lungs, including the aerosol-generating device, the size distribution of the inhaled aerosol, the gas-flow rate, the inhalation pattern and the type of interface [5][6][7][8][9].…”

mentioning

confidence: 99%

Investigation of Fugitive Aerosols Released into the Environment during High-Flow Therapy

et al. 2019

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Background: Nebulised medical aerosols are designed to deliver drugs to the lungs to aid in the treatment of respiratory diseases. However, an unintended consequence is the potential for fugitive emissions during patient treatment, which may pose a risk factor in both clinical and homecare settings. Methods: The current study examined the potential for fugitive emissions, using albuterol sulphate as a tracer aerosol during high-flow therapy. A nasal cannula was connected to a head model or alternatively, a interface was connected to a tracheostomy tube in combination with a simulated adult and paediatric breathing profile. Two aerodynamic particle sizers (APS) recorded time-series aerosol concentrations and size distributions at two different distances relative to the simulated patient. Results: The results showed that the quantity and characteristics of the fugitive emissions were influenced by the interface type, patient type and supplemental gas-flow rate. There was a trend in the adult scenarios; as the flow rate increased, the fugitive emissions and the mass median aerodynamic diameter (MMAD) of the aerosol both decreased. The fugitive emissions were comparable when using the adult breathing profiles for the nasal cannula and tracheostomy interfaces; however, there was a noticeable distinction between the two interfaces when compared for the paediatric breathing profiles. The highest recorded aerosol concentration was 0.370 ± 0.046 mg m−3 from the tracheostomy interface during simulated paediatric breathing with a gas-flow rate of 20 L/min. The averaged MMAD across all combinations ranged from 1.248 to 1.793 µm by the APS at a distance of 0.8 m away from the patient interface. Conclusions: Overall, the results highlight the potential for secondary inhalation of fugitive emissions released during simulated aerosol treatment with concurrent high-flow therapy. The findings will help in developing policy and best practice for risk mitigation from fugitive emissions.

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Inhaled salbutamol dose delivered by jet nebulizer, vibrating mesh nebulizer and metered dose inhaler with spacer during invasive mechanical ventilation

Cited by 47 publications

References 34 publications

Effects of Fill Volume and Humidification on Aerosol Delivery During Single-Limb Noninvasive Ventilation

Effects of Fill Volume and Humidification on Aerosol Delivery During Single-Limb Noninvasive Ventilation

Performance of Large Spacer Versus Nebulizer T-Piece in Single-Limb Noninvasive Ventilation

Investigation of Fugitive Aerosols Released into the Environment during High-Flow Therapy

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