title: In vitro aerodynamic characteristics of aerosol delivered from different inhalation methods in mechanical ventilation.
abstract: Aerodynamic characteristics of aerosol delivery during invasive mechanical ventilation (IMV) are mostly determined by inserting cascade impactor in the circuit. Impactor might have some effect on airflow within IMV. Hence, the aim of the present study was to develop and evaluate new in vitro aerodynamic characterization methodology without affecting airflow in IMV. Breathing simulator was set in standard adult IMV circuit with inspiratory and expiratory pressures of 20 and 5 cm H2O, 1:3 inspiratory-expiratory ratio, 15 breaths min-1, and tidal volume of 500 ml. Two ml of salbutamol solution containing 10,000 μg was nebulized using three different vibrating mesh nebulizers (VMNs) and Sidestream jet nebulizer (JET). Sixteen-metered doses, containing 100 μg salbutamol each, were delivered using three different spacers. Each device was placed in inspiration limb of Y-piece of ventilator tubing. Aerodynamic characteristics of aerosol delivered were measured using cooled Andersen cascade impactor, with mixing inlet connected to it. VMNs used had significantly more total mass in the impactor (p < .001) and fine particle dose (p < .001) compared to JET. Spacers used had higher total mass in the impactor percent (p < .001) and fine particle fraction compared to nebulizers. The in vitro IMV methodology setting suggested here showed encouraging results in comparison of different aerosol delivery systems in intubated patient.
authors: a Department of Clinical Pharmacy, Teaching Hospital of Faculty of Medicine , Fayoum University , Fayoum , Egypt.
authors: Muhammad H E
authors: MHE
authors: ElHansy
authors: b Department of Clinical Pharmacy, Faculty of Pharmacy , Beni-Suef University , Beni-Suef , Egypt.
authors: Marina E
authors: ME
authors: Boules
authors: c Department of Clinical Pharmacy, Teaching Hospital of Faculty of Medicine , Beni-Suef University , Beni-Suef , Egypt.
authors: Heba
authors: H
authors: Farid
authors: d Inhalation Consultancy Ltd. , Leeds , UK.|e Faculty of Health and Human Sciences, Plymouth University , Plymouth , UK.
authors: Henry
authors: H
authors: Chrystyn
authors: f Department of Critical Care, Faculty of Medicine , Beni-Suef University , Beni-Suef , Egypt.
authors: Sameh Kamal
authors: SK
authors: El-Maraghi
authors: f Department of Critical Care, Faculty of Medicine , Beni-Suef University , Beni-Suef , Egypt.
authors: Mohamed Bakry
authors: MB
authors: Al-Kholy
authors: g Department of Chest Diseases, Faculty of Medicine , Cairo University , Cairo , Egypt.
authors: Assem Fouad Mohamed
authors: AFM
authors: El-Essawy
authors: h Department of Analytical Chemistry, Faculty of Pharmacy , Beni-Suef University , Beni-Suef , Egypt.
authors: Maha M
authors: MM
authors: Abdelrahman
authors: b Department of Clinical Pharmacy, Faculty of Pharmacy , Beni-Suef University , Beni-Suef , Egypt.
authors: Amira S A
authors: ASA
authors: Said
authors: b Department of Clinical Pharmacy, Faculty of Pharmacy , Beni-Suef University , Beni-Suef , Egypt.
authors: Raghda R S
authors: RRS
authors: Hussein
authors: b Department of Clinical Pharmacy, Faculty of Pharmacy , Beni-Suef University , Beni-Suef , Egypt.
authors: Hoda
authors: H
authors: Rabea
authors: b Department of Clinical Pharmacy, Faculty of Pharmacy , Beni-Suef University , Beni-Suef , Egypt.
authors: Mohamed E A
authors: http://orcid.org/0000-0003-0227-8404
authors: MEA
authors: Abdelrahim
mesh_terms: D000280:Administration, Inhalation; D000336:Aerosols; D000420:Albuterol; D001993:Bronchodilator Agents; D006801:Humans; D009330:Nebulizers and Vaporizers; D010316:Particle Size; D012121:Respiration, Artificial
chemical_list: D000336:Aerosols; D001993:Bronchodilator Agents; D000420:Albuterol
keywords: Anderson cascade impactor; Salbutamol; aerodynamic characterization; endotracheal tube; invasive positive pressure ventilation; mixing inlet; nebulizer; spacer