Jiang Zhenjie, Liang Hanwen, Peng Guixia, Wang Shiya, Zhang Baozhu, Sun Qingwen, Xu Yuanda, Zeng Huiqing, Huang Jingye
Department of Critical Care Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Guangzhou Respiratory Health Research Institute, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Ann Transl Med. 2022 Feb;10(4):189. doi: 10.21037/atm-22-84.
Interferon (IFN) is widely used in clinical practice and nebulization inhalation is one of the commonly used routes of administration. However, nebulization drugs such as interferon-α (IFN-α) with large molecular weights may deposit in the membrane of the breathing filters, causing its resistance to gradually increase. Thus, our study explores the effect of IFN-α and other nebulization drugs on the resistance of breathing circuit filters under invasive mechanical ventilation.
We divided 96 breathing filters into eight groups. The baseline group was not treated while the blank group was installed but were not nebulized. The remaining groups received jet nebulized or vibrating nebulized with either normal saline, Combivent, Amphotericin B, or IFN-α at a frequency of once every 12 hours separately and were removed from the breathing circuit after 24 hours. The resistance of the filter of each group was then measured and statistical comparisons were made.
Filter resistance of the IFN-α jet nebulization group was greater than that of the other groups, and there were statistical differences except for the Amphotericin B jet nebulization group. Comparison of the resistance [cmHO/(L·s)] of the IFN-α jet nebulization group . the baseline group showed 2.56 (2.40, 2.68) . 2.26 (2.03, 2.40), P=0.037; of the IFN-α jet nebulization group . the blank group showed 2.56 (2.40, 2.68) . 2.11 (1.98, 2.27), P=0.003; of the IFN-α jet nebulization group . the normal saline group: 2.56 (2.40, 2.68) . 2.16 (2.08, 2.32), P=0.023; of the IFN-α jet nebulization group . the Combivent jet nebulization group: 2.56 (2.40, 2.68) . 2.18 (2.14, 2.27), P=0.018; and of the IFN-α jet nebulization group . the Amphotericin B jet nebulization group: 2.56 (2.40, 2.68) . 2.33 (2.05, 2.45), P=0.221. The effect of jet nebulization and vibrating mesh nebulization on the resistance of breathing filters showed no significant statistical difference.
Jet nebulization with IFN-α significantly increased the resistance of the breathing filter within 24 hours and there was no significant difference in filter resistance between jet nebulization and vibrating mesh nebulization of IFN-α or Amphotericin B.
干扰素（IFN）在临床实践中广泛应用，雾化吸入是常用的给药途径之一。然而，分子量较大的雾化药物如α-干扰素（IFN-α）可能沉积在呼吸过滤器膜上，导致其阻力逐渐增加。因此，本研究探讨IFN-α和其他雾化药物对有创机械通气下呼吸回路过滤器阻力的影响。
将96个呼吸过滤器分为八组。基线组未进行处理，空白组安装了过滤器但未进行雾化。其余各组分别接受生理盐水、可必特、两性霉素B或IFN-α的喷射雾化或振动雾化，频率为每12小时一次，24小时后从呼吸回路中取出。然后测量每组过滤器的阻力并进行统计学比较。
IFN-α喷射雾化组的过滤器阻力大于其他组，除两性霉素B喷射雾化组外均有统计学差异。IFN-α喷射雾化组与基线组阻力[cmH₂O/(L·s)]比较：2.56(2.40,2.68)比2.26(2.03,2.40)，P = 0.037；IFN-α喷射雾化组与空白组比较：2.56(2.40,2.68)比2.11(1.98,2.27)，P = 0.003；IFN-α喷射雾化组与生理盐水组比较：2.56(2.40,2.68)比2.16(2.08,2.32)，P = 0.023；IFN-α喷射雾化组与可必特喷射雾化组比较：2.56(2.40,2.68)比2.18(2.14,2.27)，P = 0.018；IFN-α喷射雾化组与两性霉素B喷射雾化组比较：2.56(2.40,2.68)比2.33(2.05,2.45)，P = 0.221。喷射雾化和振动筛孔雾化对呼吸过滤器阻力的影响无显著统计学差异。
IFN-α喷射雾化在24小时内显著增加呼吸过滤器的阻力，IFN-α或两性霉素B的喷射雾化与振动筛孔雾化之间的过滤器阻力无显著差异。
