雾化器类型、输送接口和流速对自主呼吸儿科和婴儿肺模型中气溶胶药物输送的影响。
Effect of nebulizer type, delivery interface, and flow rate on aerosol drug delivery to spontaneously breathing pediatric and infant lung models.
机构信息
Department of Respiratory Care, College of Health Professions, Texas State University, Round Rock, Texas.
出版信息
Pediatr Pulmonol. 2019 Nov;54(11):1735-1741. doi: 10.1002/ppul.24449. Epub 2019 Jul 16.
BACKGROUND
Different types of nebulizers, interfaces, and flow rates are used to deliver aerosolized medications to children. The purpose of this study was to determine the effect of nebulizer type, delivery interface, and flow rate on aerosol drug delivery to spontaneously breathing pediatric and infant lung models.
METHODOLOGY
A teaching mannequin was attached to a sinusoidal pump via a collecting filter at the bronchi to simulate a spontaneously breathing child (Vt: 250 mL, RR: 20 bpm and Ti: 1 second) and infant (Vt = 100 mL, RR = 30 bpm, Ti: 0.7 seconds). Albuterol sulfate was nebulized with jet (Misty Max 10; Cardinal Health) and mesh (Aerogen Solo; Aerogen) nebulizers using a low-flow nasal cannula (LFNC; Hudson), a high-flow nasal cannula (HFNC; Fisher & Paykel), face mask (FM; Hudson), and mouthpiece (MP; Cardinal Health). While all interfaces were used in the pediatric study, only LFNC, HFNC, and FM were tested in the infant study. The mesh nebulizer was tested at 2, 4, and 6 L/min with LFNC, 4 and 6 L/min with HFNC, and 6 L/min with FM and MP. The jet nebulizer was operated at 6 and 8 L/min with FM and 6 L/min with LFNC, HFNC, and MP (n = 5). The drug was eluted from the filter and analyzed by spectrophotometry. Factorial analysis of variance and post hoc comparisons were used for data analysis. P < .05 was considered statistically significant.
RESULTS
Delivery efficiency of mesh nebulizers is two to fourfold more than jet nebulizers used with HFNC, FM, and MP. No statistical difference was found between jet and mesh nebulizers used with LFNC in infants (P = .643) and pediatrics (P = .255). Aerosol delivery with MP was the best compared to other interfaces used in pediatrics (P < .05). As the second-best interface in aerosol drug delivery, the delivery efficiency of FM was greater than HFNC (P = .0001) and LFNC (P = .0001). Increasing flow rate with LFNC and HFNC decreased aerosol delivery with the mesh nebulizer in both infants and pediatrics.
CONCLUSION
The type of nebulizer, delivery interface, and flow rate used in the treatment of children affect aerosol drug delivery.
背景
不同类型的雾化器、接口和流量用于向儿童输送雾化药物。本研究的目的是确定雾化器类型、输送接口和流量对模拟自主呼吸的儿科和婴儿肺模型中气溶胶药物输送的影响。
方法
通过支气管处的收集过滤器将教学模型连接到正弦波泵上，以模拟自主呼吸的儿童（VT：250ml，RR：20 次/分钟，Ti：1 秒）和婴儿（VT=100ml，RR：30 次/分钟，Ti：0.7 秒）。硫酸沙丁胺醇通过喷射式（Misty Max 10；Cardinal Health）和网格式（Aerogen Solo；Aerogen）雾化器进行雾化，使用低流量鼻插管（LFNC；Hudson）、高流量鼻插管（HFNC；Fisher & Paykel）、面罩（FM；Hudson）和接口（MP；Cardinal Health）。虽然所有接口都在儿科研究中使用，但仅在婴儿研究中测试 LFNC、HFNC 和 FM。网格式雾化器在 LFNC 下测试 2、4 和 6L/min，在 HFNC 下测试 4 和 6L/min，在 FM 和 MP 下测试 6L/min。喷射式雾化器在 FM 下以 6 和 8L/min 运行，在 LFNC、HFNC 和 MP 下以 6L/min 运行（n=5）。药物从过滤器洗脱并通过分光光度法分析。数据采用方差分析和事后比较进行分析。P<.05 被认为具有统计学意义。
结果
与 HFNC、FM 和 MP 一起使用的网格式雾化器的输送效率比喷射式雾化器高两到四倍。在婴儿（P=.643）和儿科（P=.255）中，使用 LFNC 时，喷射式和网格式雾化器之间没有统计学差异。与儿科中使用的其他接口相比，MP 的气溶胶输送效果最好（P<.05）。作为气溶胶药物输送的第二好接口，FM 的输送效率大于 HFNC（P=.0001）和 LFNC（P=.0001）。LFNC 和 HFNC 流量增加会降低儿童使用网格式雾化器的气溶胶输送。
结论
儿童治疗中使用的雾化器类型、输送接口和流量会影响气溶胶药物输送。
Zotero 插件