title: In vitro comparison of heliox and oxygen in aerosol delivery using pediatric high flow nasal cannula.
abstract: Drug administration via high flow nasal cannula (HFNC) has been described in pediatrics but the amount of albuterol delivery with an HFNC is not known. The purpose of this study is to quantify aerosol delivery with heliox and oxygen (O(2)) in a model of pediatric ventilation. A vibrating mesh nebulizer (Aeroneb Solo, Aerogen) was placed on the inspiratory inlet of a heated humidifier and heated wire circuit attached to a pediatric nasal cannula (Optiflow, Fisher & Paykel). Breathing parameters were tidal volume (V(t)) 100 ml, respiratory rate (RR) 20/min, and I-time of 1 sec. Albuterol sulfate (2.5 mg/3 ml) was administered through a pediatric HFNC with O(2) (100%) and heliox (80/20% mixture). A total of 12 runs, using O(2) and heliox were conducted at 3 and 6 L/min (n = 3). Drug was collected on an absolute filter, eluted and measured using spectrophotometry. The percent inhaled dose (mean ± SD) was similar with heliox and O(2) at 3 L/min (11.41 ± 1.54 and 10.65 ± 0.51, respectively; P = 0.465). However at 6 L/min drug deposition was ≥ 2-fold greater with heliox (5.42 ± 0.54) than O(2) (1.95 ± 0.50; P = 0.01). Using a pediatric model of HFNC, reducing delivered flow from 6 to 3 L/min increased inhaled albuterol delivery ≥ 2-fold but eliminated the increase in inhaled drug efficiency associated with heliox.
authors: Georgia State University, Division of Respiratory Therapy, Atlanta, Georgia 30302-4019, USA. aari1@gsu.edu
authors: Arzu
authors: A
authors: Ari
authors: Robert
authors: R
authors: Harwood
authors: Meryl
authors: M
authors: Sheard
authors: Patricia
authors: P
authors: Dailey
authors: James B
authors: JB
authors: Fink
mesh_terms: D000280:Administration, Inhalation; D000336:Aerosols / Q000008:administration & dosage; D000420:Albuterol / Q000008:administration & dosage; D001993:Bronchodilator Agents / Q000008:administration & dosage; D057785:Catheters; D002675:Child, Preschool; D006371:Helium / Q000008:administration & dosage*; D006801:Humans; D066298:In Vitro Techniques; D007223:Infant; D007231:Infant, Newborn; D009330:Nebulizers and Vaporizers; D010100:Oxygen / Q000008:administration & dosage*; D012119:Respiration
chemical_list: D000336:Aerosols; D001993:Bronchodilator Agents; D006371:Helium; C038949:heliox; D000420:Albuterol; D010100:Oxygen