Abdelrahim, Mohamed. E, Plant, Paul and Chrystyn, Henry (2010) In-vitro characterisation of the nebulised dose during non-invasive ventilation. Journal of Pharmacy and Pharmacology, 62 (8). pp. 966-972. ISSN 0022-3573

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.

Add to AnyAdd to TwitterAdd to FacebookAdd to LinkedinAdd to PinterestAdd to Email