Radioaerosol Pulmonary Deposition Using Mesh and Jet Nebulizers During Noninvasive Ventilation in Healthy Subjects.

BACKGROUND: In vivo deposition studies of aerosol administration during noninvasive ventilation (NIV) are scarce in the literature. The aim of this study was to compare radioaerosol pulmonary index and radioaerosol mass balance in the different compartments (pulmonary and extrapul-monary) of radio-t...

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Publicado en:Respiratory Care Vol. 60; no. 9; pp. 1238 - 1247
Autores principales: Galindo-Filho, Valdecir C., Ramos, Maria Eveline, Rattes, Catarina S. F., Barbosa, Antônio K., Brandão, Daniella C., Brandão, Simone Cristina S., Fink, James B., Dornelas de Andrade, Armèle
Formato: diagnostic images pictorial research tables/charts randomized controlled trial Journal Article
Publicado: Mary Ann Liebert, Inc. Sep2015
Acceso en línea:Ver este registro en EBSCOhost
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          Galindo-Filho, Valdecir C.
          Ramos, Maria Eveline
          Rattes, Catarina S. F.
          Barbosa, Antônio K.
          Brandão, Daniella C.
          Brandão, Simone Cristina S.
          Fink, James B.
          Dornelas de Andrade, Armèle
        affil: Department of Physical Therapy, Universidade Federal de Peraambuco, Recife City, Pernambuco, Brazil
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        subj:
          Nebulizers and Vaporizers
          Noninvasive Procedures
          Aerosols Therapeutic Use
          Respiration, Artificial
          Radioisotopes
          Equipment and Supplies
          Human
          Education, Medical, Continuing
          Radionuclide Imaging
          Descriptive Statistics
          Crossover Design
          Randomized Controlled Trials
          Brazil
          Adolescence
          Adult
          Middle Age
          Chelating Agents Therapeutic Use
          Masks
          Male
          Female
          Pilot Studies
          Repeated Measures
          Data Analysis Software
          Friedman Test
          Post Hoc Analysis
          Confidence Intervals
          In Vivo Studies
          Lung
          Funding Source
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: BACKGROUND: In vivo deposition studies of aerosol administration during noninvasive ventilation (NIV) are scarce in the literature. The aim of this study was to compare radioaerosol pulmonary index and radioaerosol mass balance in the different compartments (pulmonary and extrapul-monary) of radio-tagged aerosol administered using vibrating mesh nebulizers and conventional jet nebulizers during NIV. METHODS: This was a crossover clinical trial involving 10 healthy subjects (mean age of 33.7 ± 10.0 y) randomly assigned to both treatment arms of this study: group 1 (NIV + vibrating mesh nebulizer, n = 10) and group 2 (NIV + jet nebulizer, n = 10). All subjects inhaled 3 mL of technetium-99m diethylenetriaminepentaacetic acid (25 mCi) and 0.9% saline solution via vibrating mesh and jet nebulizers during NIV through a face mask secured with straps while receiving positive inspiratory and expiratory pressures of 12 and 5 cm H2O, respectively. Scintigraphy was performed to count radioaerosol particles deposited in the regions of interest to determine radioaerosol mass balance from the lungs, upper airways, stomach, nebulizer, ventilator circuit, inspiratory and expiratory filters, and mask as a percentage. RESULTS: Vibrating mesh nebulizers deposited 972,013 ± 214,459 counts versus jet nebulizer with 386,025 ± 130,363 counts (P = .005). In a determination of mass balance, vibrating mesh nebulizers showed a higher deposition of inhaled radioaerosol compared with jet nebulizers (23.1 ± 5.8% vs 6.1 ± 2.5%, P = .005) and a higher proportion of radioaerosol deposited into the lungs (5.5 ± 0.9% versus 1.5 ± 0.6%, respectively, P = .005). The residual drug volume was lower with vibrating mesh nebulizers (5.1 ± 1.5%) compared with jet nebulizers (41.3 ± 4.2%, P = .005). CONCLUSIONS: During NIV in healthy subjects, vibrating mesh nebulizers delivered > 2-fold more radiolabeled drug into the respiratory tract compared with conventional jet nebulizers. Additional studies are recommended in subjects with asthma, COPD, bronchiectasis, and cystic fibrosis to better understand differences in both aerosol delivery and response.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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