Department of Medical Engineering, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan.
Department of Clinical Research, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan.
Respir Care. 2019 May;64(5):502-508. doi: 10.4187/respcare.06348. Epub 2019 Mar 19.
Intrapulmonary percussive ventilation (IPV) is used for airway clearance and delivery of aerosol medications, including bronchodilators. Despite the common use of IPV for drug delivery, few data are available regarding optimization of inhalation therapy with IPV. In this study, we investigated the influence of IPV setting parameters and lung mechanics on drug delivery via IPV alone.
An IPV device was connected to a lung model via a trachea model and a flow analyzer. Albuterol nebulized from the IPV device was collected onto a filter attached between the trachea and lung models, and was quantitated by spectrophotometry (230 nm).
Albuterol delivery to the lung model was increased up to 2.1-fold, with decreasing percussion frequency. Decreasing percussion frequency concomitantly increased the tidal volume, and albuterol delivery was correlated with tidal volume (r = 0.91, < .001). Airway resistance had a negative impact on albuterol delivery, whereas lung compliance had no significant effect. Increasing operational pressure increased albuterol delivery while increasing peak inspiratory pressure.
Albuterol delivery and tidal volume with IPV can be improved by maintaining low levels of percussion frequency and increasing operational pressure. When increasing operational pressure, the peak inspiratory pressure and airway resistance levels need to be carefully monitored for safe inhalation therapy with IPV.
肺内叩击通气（IPV）用于气道清除和气溶胶药物输送，包括支气管扩张剂。尽管 IPV 常用于药物输送，但关于通过 IPV 优化吸入治疗的数据很少。在这项研究中，我们研究了 IPV 设置参数和肺力学对单独使用 IPV 进行药物输送的影响。
通过气管模型和流量分析仪将 IPV 设备连接到肺模型。从 IPV 设备雾化的沙丁胺醇被收集在气管和肺模型之间的过滤器上，并通过分光光度法（230nm）定量。
随着叩击频率的降低，沙丁胺醇输送到肺模型的比例增加了 2.1 倍。随着叩击频率的降低，潮气量增加，沙丁胺醇输送与潮气量呈正相关（r = 0.91， <.001）。气道阻力对沙丁胺醇输送有负面影响，而肺顺应性没有显著影响。增加操作压力可增加沙丁胺醇输送量，同时增加峰吸气压。
通过保持低水平的叩击频率和增加操作压力，可以提高 IPV 的沙丁胺醇输送和潮气量。当增加操作压力时，需要仔细监测峰吸气压和气道阻力水平，以确保安全使用 IPV 进行吸入治疗。
