In-vitro characterisation of the nebulised dose during non-invasive ventilation
Article first published online: 21 JUL 2010
© 2010 The Authors. Journal compilation © 2010 Royal Pharmaceutical Society of Great Britain
Journal of Pharmacy and Pharmacology
Volume 62, Issue 8, pages 966–972, August 2010
How to Cite
Abdelrahim, M. E., Plant, P. and Chrystyn, H. (2010), In-vitro characterisation of the nebulised dose during non-invasive ventilation. Journal of Pharmacy and Pharmacology, 62: 966–972. doi: 10.1111/j.2042-7158.2010.01134.x
- Issue published online: 21 JUL 2010
- Article first published online: 21 JUL 2010
- Received October 20, 2009Accepted April 26, 2010
- aerodynamic characteristics;
- Next Generation Impactor;
- non-invasive ventilation;
Objectives Non-invasive ventilation (NIV) with nebulised bronchodilators helps some patients to maintain effective ventilation. However, the position of the nebuliser in the ventilation circuit may affect lung delivery.
Methods We placed the nebuliser proximal (A) and distal (B) to a breathing simulator in a standard NIV circuit with inspiratory (I) and expiratory (E) pressures of 20 and 5 cm H2O, 1 : 3 I : E ratio, 15 breaths/min and a tidal volume of 500 ml. Five milligrams of terbutaline solution was nebulised using an Aeroneb Pro (AERO) and a Sidestream (SIDE) nebuliser. The fate of the nebulised dose was determined and the aerodynamic droplet characteristics were measured using a cooled Next Generation Impactor.
Key findings More terbutaline was entrained on the inhalation filter in position A than in position B (P < 0.001) for both nebulisers. These amounts were greater (P < 0.001) for AERO than SIDE due to a smaller (P < 0.001) residual volume. The mean (SD) fine particle doses for AEROA, AEROB, SIDEA and SIDEB were 1.31 (0.2), 1.13 (0.14), 0.56 (0.03) and 0.39 (0.13) mg. These amounts from AEROA were significantly greater (P < 0.001) than those of the other three methods.
Conclusions The results highlight the differences between nebulisers and the influence on the placement of the nebuliser in the NIV circuit.