Aerosol Delivery Characterisation during Simulated Mechanical Ventilation of a Neonate

Title: Aerosol Delivery Characterisation during Simulated Mechanical Ventilation of a Neonate
Author(s): L. Gallagher, M. Joyce, E. Fernández Fernández, & R. MacLoughlin
Institution: Aerogen Ltd
Poster: Click to view poster
Category: General Respiratory and Sleep
Abstract: Aerosol therapy is commonly prescribed during mechanical ventilation within the neonatal intensive care setting. The objective of this study was to characterise aerosol delivery using a vibrating mesh nebuliser (VMN) and jet nebuliser (JN) at two circuit positions during simulated neonatal mechanical ventilation in an infant incubator.

A VMN (Aerogen Solo, Aerogen, Ireland) and JN (Cirrus™2, Intersurgical, UK) were placed at the dry side and 30 cm before the wye within a humidified circuit (Fisher & Paykel, New Zealand) connected to a Servo-U Ventilator (Getinge, Germany)(Vt12mL, 60BPM, I:E 1:2). A 3.0mm endotracheal tube (ETT) was attached to a test lung and placed within an isolette (Dräger Air-Shields C2000, Germany) at 37°C. 2000 µg salbutamol was nebulised, and aerosol was captured distal to the ETT(n=5). Lung dose was quantified using UV-spectrophotometry (276nm).

The VMN delivered significantly higher lung dose (µg) positioned 30cm before the WYE compared to the dry side (155.45 ± 9.71 vs 40.00 ± 8.20, P=0). There was no significant difference in lung dose (µg) for the JN at 30cm before the WYE or at the dry side (31.21 ± 4.37 vs 33.94 ± 6.83, P=0.48). The VMN delivered significantly higher lung dose (µg) compared to the JN positioned 30cm before the WYE but not at the dry side (155.45 ± 9.71 vs 31.21 ± 4.37, P=0 and 40.00 ± 8.20 vs 33.94 ± 6.83, P=0.25 respectively).

Results indicate that nebuliser type and circuit position significantly impact aerosol delivery in a simulated mechanically ventilated neonate, with the VMN being the most efficient device when located outside the isolette, 30 cm before the wye.