Albuterol delivery via metered dose inhaler in a spontaneously breathing pediatric tracheostomy model

Berlinski, Ariel; Chavez, Alma

doi:10.1002/ppul.22715

Cited by 17 publications

(46 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…11,12,16 During tracheostomy delivery, lung dose was lower for the 50-mL tidal volume but was similar between the breathing patterns with 155 and 300 mL. This finding is in agreement and disagreement with previous reports.…”

Section: Discussioncontrasting

confidence: 56%

“…The model was operated in the vertical position as previously reported. 11,12 After selecting a breathing pattern, the accuracy of the tidal volume was verified using a mass flow meter (TSI, Shoreview, Minnesota). 11,12 The seal between the head/airway model and the mask was achieved with putty.…”

Section: What This Paper Contributes To Our Knowledgementioning

confidence: 99%

“…11,12 After selecting a breathing pattern, the accuracy of the tidal volume was verified using a mass flow meter (TSI, Shoreview, Minnesota). 11,12 The seal between the head/airway model and the mask was achieved with putty. 12 The pMDI was primed with 4 puffs at the beginning of every testing day and was shaken for 5 s before each actuation.…”

Section: What This Paper Contributes To Our Knowledgementioning

confidence: 99%

“…12 A total of 10 actuations were utilized to improve drug recovery, and the used filter was processed for albuterol concentration. 11,12 The VHCs were cleaned and air-dried, and lack of residual drug was verified by spectrophotometry. This process was done for each of the 2 devices (pMDI and SMI) and for each of the 3 breathing patterns (infant, child, and older child).…”

Section: What This Paper Contributes To Our Knowledgementioning

confidence: 99%

“…9 Due to the paucity of clinical studies, most of our insight on optimization of aerosol delivery with pMDIs and VHCs through tracheostomy derives from in vitro studies. [10][11][12] Those studies reported that the type of VHC, breathing patterns, and other factors affect drug delivery of pMDI through tracheostomies. Recently, Cooper et al 12 compared oronasal and tracheostomy delivery of albuterol using a pMDI with 2 different VHCs and a continuous output jet nebulizer.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Oronasal and Tracheostomy Delivery of Soft Mist and Pressurized Metered-Dose Inhalers With Valved Holding Chamber

Berlinski

Cooper

2016

Respir Care

View full text Add to dashboard Cite

BACKGROUND: Some pediatric tracheostomized patients who receive inhaled drugs undergo decannulation, and it is unknown whether the dose has to be adjusted. Pressurized metereddose inhalers (pMDIs) and soft mist inhalers (SMIs) used with valved holding chambers (VHCs) made of non-electrostatic material are available. We hypothesized that using an SMI and changing the delivery route from tracheostomy to oronasal would increase lung dose. METHODS: Four units of a metallic VHC were studied with albuterol hydrofluoroalkane (pMDI) and albuterol/ipratropium bromide with an SMI using an anatomically correct in vitro model of a 5-y-old spontaneously breathing tracheostomized child. The drug was captured in a filter and was termed lung dose. We tested breathing patterns with tidal volumes of 50, 155, and 300 mL. A mask and a special adapter were used as interfaces for oronasal and tracheostomy delivery, respectively. Spectrophotometry (276 nm) was used to determine albuterol concentration. RESULTS: The use of SMI resulted in a higher lung dose than the pMDI for all tested conditions except delivery through tracheostomy with tidal volume of 155 mL (P ‫؍‬ .69). Switching from oronasal to tracheostomy delivery increased the lung dose for all tested conditions except for the pMDI with the 300-mL tidal volume (P ‫؍‬ .83). The use of SMI resulted in higher deposition in the tracheostomy tube than the pMDI. CONCLUSIONS: In general, an SMI delivers a higher lung dose than a pMDI when using a metallic spacer during oronasal and tracheostomy route with the latter providing a higher lung dose.

show abstract

Section: Discussioncontrasting

confidence: 56%

Section: What This Paper Contributes To Our Knowledgementioning

confidence: 99%

Section: What This Paper Contributes To Our Knowledgementioning

confidence: 99%

Section: What This Paper Contributes To Our Knowledgementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Oronasal and Tracheostomy Delivery of Soft Mist and Pressurized Metered-Dose Inhalers With Valved Holding Chamber

Berlinski

Cooper

2016

Respir Care

View full text Add to dashboard Cite

show abstract

Inhaled Drug Delivery for Children on Long-term Mechanical Ventilation

Berlinski

2016

Respiratory Medicine

View full text Add to dashboard Cite

In-Vitro Characterization of the Aerosolized Dose During Non-Invasive Automatic Continuous Positive Airway Pressure Ventilation

et al. 2015

View full text Add to dashboard Cite

Introduction: Many devices (e.g., nebulizers and spacers) are used to deliver aerosol in a non-invasive ventilation circuit (NIV) without any special recommendation. The aim of the present work was to compare the doses delivered from seven different aerosol delivery systems when placed in the NIV using automatic continuous positive airway pressure (Auto-CPAP). Methods: Three spacers and three vibrating mesh nebulizers were compared to a Sidestream jet nebulizer (SIDE). Each device was placed proximal to a breathing simulator in a standard NIV circuit with a 500 ml tidal volume, 15 breaths/min and a 1:3 inspiratory-expiratory ratio. Two ml of salbutamol solution containing 10,000 lg was nebulized using Aerogen Pro (PRO), Aerogen Solo (SOLO), NIVO and SIDE. Twelve metered dose inhaler doses, containing 100 lg salbutamol each, were delivered using AeroChamber MV (AC), AeroChamber Vent (VC) and AeroChamber Mini (MC). Total emitted dose (TED) and its percentage were determined. Aerodynamic droplet characteristics were measured using cooled Andersen Cascade Impactor. Results: The vibrating mesh nebulizers used had significantly more (p\0.001) TED compared to the jet nebulizer. The spacers used had higher TED % (p\0.001) compared to the nebulizers. The fine particle fraction of SIDE was the highest (p = 0.021) and mass median aerodynamic diameter of the spacers was the smallest (p = 0.001). The fine particle dose from vibrating mesh nebulizers was the greatest (p = 0.02).

show abstract

Albuterol delivery via metered dose inhaler in a spontaneously breathing pediatric tracheostomy model

Abstract: Aerotrach Plus and the adapter were the most and least efficient devices respectively. Tracheostomy size and breathing pattern affected drug delivery. The use of assisted technique reduced aerosol delivery.

Cited by 17 publications

References 30 publications

Oronasal and Tracheostomy Delivery of Soft Mist and Pressurized Metered-Dose Inhalers With Valved Holding Chamber

Oronasal and Tracheostomy Delivery of Soft Mist and Pressurized Metered-Dose Inhalers With Valved Holding Chamber

Inhaled Drug Delivery for Children on Long-term Mechanical Ventilation

In-Vitro Characterization of the Aerosolized Dose During Non-Invasive Automatic Continuous Positive Airway Pressure Ventilation

Contact Info

Product

Resources

About