![]() Although a 40% reduction was reported in the previous studies that used heated humidified ventilator circuits, they did not simulate active heating and humidity during expiration. ![]() Furthermore, research on aerosol therapy in children mainly consists of in vitro studies that did not investigate the effect of exhaled humidity on aerosol drug delivery to this patient population. ![]() Regardless of the ventilatory support that they receive, the same drug dose was used. However, many children move between mechanical ventilation, noninvasive ventilation, and spontaneous breathing during their course of care. Furthermore, treatment and dose may vary from patient to patient depending on the mode of ventilatory support.Īlthough there are many publications on factors affecting aerosol drug delivery to children, no research has compared the delivery efficiency of pediatric aerosol devices in different modes of ventilation including mechanical ventilation, noninvasive ventilation, and spontaneous breathing. While nebulizers and pMDIs are commonly used in the treatment of children, they have different technical characteristics, and the selection of an aerosol device should be age-appropriate and individualized based on the patient’s psychomotor skills. Because an optimal inspiratory flow rate is essential for the correct use of dry powder inhalers (DPI), children who are in acute conditions or younger than 6 years of age may not have the physical or cognitive abilities to achieve the required DPI flow rate. According to previous research, poor hand strength, inadequate breath holding and inappropriate inspiratory flow may be an issue with pressurized metered dose inhalers (pMDIs). Since most aerosol devices require multiple steps for optimum use, the correct delivery of aerosol therapy poses problems for children. In addition, the lack of patient and parental education leads to ineffective delivery of aerosolized medications. Delivered dose with JN was similar during MV, NIV, and SB, although the delivery efficiency of MN differs with different modes of ventilation.Īlthough a broad variety of aerosol devices and interfaces are on the market, they are designed for adults and require several steps to be used effectively. The delivery efficiency of MN was up to 3-fold more than JN during MV ( p = 0.008), NIV ( p = 0.005), and SB ( p = 0.009). Aerosol delivery with JN was not significantly different during MV, NIV, and SB ( p = 0.075), while inhaled dose obtained with MN during MV was greater than NIV and SB ( p = 0.001). Albuterol sulfate (2.5 mg/3 mL) was delivered, and the drug deposited on an absolute filter was eluted and analyzed with spectrophotometry. A heated humidifier was placed between the filter and test lung to simulate exhaled humidity (35 ± 2 ☌, 100% RH) with all lung models. Drug delivery with JN (Mistymax10) and MN (Aerogen Solo) was compared during SB, NIV, and MV using three different lung models set to simulate the same breathing parameters (Vt 250 mL, RR 20 bpm, I:E ratio 1:3). This study aims to determine the aerosol deposition with jet (JN) and mesh nebulizers (MN) during SB, NIV, and MV using a pediatric lung model. ![]() Acutely ill children may transition between spontaneous breathing (SB), noninvasive ventilation (NIV), and mechanical ventilation (MV), and commonly receive the same drug dosage with each type of ventilatory support and interface.
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