Cameron D, Clay M, Silverman M
Department of Paediatrics and Neonatal Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, UK.
Crit Care Med. 1990 Aug;18(8):866-70. doi: 10.1097/00003246-199008000-00015.
The use of nebulizers in neonatal ventilator circuits offers a new and relatively uncharted route of therapy for infants in respiratory failure. We used a model lung to investigate and compare different nebulizer types and therapeutic agents and to make practical observations. Five different nebulizers (Ultravent, Acorn, MAD2, Small Particle Aerosol Generator, and Pulmosonic) were compared for efficiency of delivery of an amino-phylline aerosol to the model lung, and the particle size of aerosol produced by them was measured. A Nebulizer Efficiency Index (NEI) was created, representing the deposition rate of the original solution as aerosol upon the model lung filter. The Acorn (2.8.10(3) ml/min) and MAD2 (2.4.10(-3) scored highest NEI. When a suspension of budesonide was nebulized, minimal amounts of drug were recovered from the filter when the nebulizer producing the smallest particle size (Ultravent) was studied, suggesting that suspensions of drugs behave differently from solutions. Significant changes need to be made to a conventional circuit when jet nebulizers are used; most of these are obviated by the use of an ultrasonic nebulizer, which also avoids the potential problem of marked cooling of the gas flow produced by jet nebulizers.
在新生儿呼吸机回路中使用雾化器为呼吸衰竭的婴儿提供了一种全新且相对未知的治疗途径。我们使用模拟肺来研究和比较不同类型的雾化器及治疗药物，并进行实际观察。比较了五种不同的雾化器（Ultravent、Acorn、MAD2、小型颗粒气溶胶发生器和Pulmosonic）向模拟肺输送氨茶碱气雾剂的效率，并测量了它们产生的气雾剂颗粒大小。创建了一个雾化器效率指数（NEI），代表原始溶液作为气雾剂在模拟肺过滤器上的沉积率。Acorn（2.8×10³毫升/分钟）和MAD2（2.4×10³）的NEI得分最高。当雾化布地奈德混悬液时，研究产生最小颗粒大小的雾化器（Ultravent）时，从过滤器中回收的药物量最少，这表明药物混悬液的行为与溶液不同。使用喷射式雾化器时，传统回路需要进行重大改变；而使用超声雾化器则可避免大部分此类问题，超声雾化器还可避免喷射式雾化器产生的气流显著冷却这一潜在问题。
