title: Improving pharmaceutical aerosol delivery during noninvasive ventilation: effects of streamlined components.
abstract: Aerosol delivery efficiency during noninvasive ventilation (NIV) is known to be low (~10%) and is associated with poor outcomes of aerosol therapy. The objective of this study was to demonstrate the benefit of redesigning ventilation circuit components using a streamlining approach to improve aerosol delivery during nasal high flow therapy in adults with a conventional-sized aerosol from a mesh nebulizer. The ventilation circuit consisted of a humidifier, mesh nebulizer, mixing T-connector (with 90° angle), 10 mm tubing, and nasal cannula interface. In vitro experiments and computational fluid dynamics analyses were used to evaluate depositional losses in a system of existing components and a newly proposed streamlined T-connector and cannula at flow rates of 30 and 45 LPM. Streamlined designs reduced deposition in the T-connector by a factor of 4. In the nasal cannula, the streamlined designs reduced depositional losses by factors of 1.25-2.0. With the streamlined designs, the highest emitted dose achieved was >40% for a conventional-sized aerosol at 30 LPM. Streamlined geometries offer an effective method to significantly improve the delivery of aerosols through components of NIV systems. This increase in delivery efficiency is important for new inhaled medications with narrow therapeutic windows, increased costs, or long delivery times.
authors: Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, 401 West Main Street, P.O. Box 843015, Richmond, VA 23284-3015, USA. pwlongest@vcu.edu
authors: P Worth
authors: PW
authors: Longest
authors: Laleh
authors: L
authors: Golshahi
authors: Michael
authors: M
authors: Hindle
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000336:Aerosols / Q000008:administration & dosage* / Q000737:chemistry; D003198:Computer Simulation; D004867:Equipment Design; D006801:Humans; D057446:Hydrodynamics; D009330:Nebulizers and Vaporizers; D063087:Noninvasive Ventilation / Q000295:instrumentation*; D010316:Particle Size; D004364:Pharmaceutical Preparations / Q000008:administration & dosage
chemical_list: D000336:Aerosols; D004364:Pharmaceutical Preparations