| Content Provider |
World Health Organization (WHO)-Global Index Medicus |
| Author |
Galindo-Filho, Valdecir C. Ramos, Maria Eveline Rattes, Catarina S. F. Barbosa, Antônio K. Brandão, Daniella C. Brandão, Simone Cristina S. Fink, James B. de Andrade, Armèle Dornelas |
| Description |
Country affiliation: Brazil Author Affiliation: Galindo-Filho VC ( Department of Physical Therapy, Universidade Federal de Pernambuco, Recife City, Pernambuco, Brazil. vcastorgalindo@yahoo.com.); Ramos ME ( Department of Physical Therapy, Universidade Federal de Pernambuco, Recife City, Pernambuco, Brazil.); Rattes CS ( Department of Physical Therapy, Universidade Federal de Pernambuco, Recife City, Pernambuco, Brazil.); Barbosa AK ( Department of Nuclear Medicine, Hospital das Clínicas de Pernambuco, Recife City, Pernambuco, Brazil.); Brandão DC ( Department of Physical Therapy, Universidade Federal de Pernambuco, Recife City, Pernambuco, Brazil.); Brandão SC ( Department of Nuclear Medicine, Hospital das Clínicas de Pernambuco, Recife City, Pernambuco, Brazil.); Fink JB ( Division of Respiratory Therapy, School of Health Professions, Georgia State University, Atlanta, Georgia, Rush University Medical Center, Chicago, Illinois, and James B Fink LLC, San Mateo, California.); de Andrade AD ( Department of Physical Therapy, Universidade Federal de Pernambuco, Recife City, Pernambuco, Brazil.) |
| Abstract |
BACKGROUND: In vivo deposition studies of aerosol administration during noninvasive ventilation (NIV) are scarce in the literature. The aim of this study was to compare radioaerosol pulmonary index and radioaerosol mass balance in the different compartments (pulmonary and extrapulmonary) of radio-tagged aerosol administered using vibrating mesh nebulizers and conventional jet nebulizers during NIV. METHODS: This was a crossover clinical trial involving 10 healthy subjects (mean age of 33.7 ± 10.0 y) randomly assigned to both treatment arms of this study: group 1 (NIV + vibrating mesh nebulizer, n = 10) and group 2 (NIV + jet nebulizer, n = 10). All subjects inhaled 3 mL of technetium-99m diethylenetriaminepentaacetic acid (25 mCi) and 0.9% saline solution via vibrating mesh and jet nebulizers during NIV through a face mask secured with straps while receiving positive inspiratory and expiratory pressures of 12 and 5 cm H2O, respectively. Scintigraphy was performed to count radioaerosol particles deposited in the regions of interest to determine radioaerosol mass balance from the lungs, upper airways, stomach, nebulizer, ventilator circuit, inspiratory and expiratory filters, and mask as a percentage. RESULTS: Vibrating mesh nebulizers deposited 972,013 ± 214,459 counts versus jet nebulizer with 386,025 ± 130,363 counts (P = .005). In a determination of mass balance, vibrating mesh nebulizers showed a higher deposition of inhaled radioaerosol compared with jet nebulizers (23.1 ± 5.8% vs 6.1 ± 2.5%, P = .005) and a higher proportion of radioaerosol deposited into the lungs (5.5 ± 0.9% versus 1.5 ± 0.6%, respectively, P = .005). The residual drug volume was lower with vibrating mesh nebulizers (5.1 ± 1.5%) compared with jet nebulizers (41.3 ± 4.2%, P = .005). CONCLUSIONS: During NIV in healthy subjects, vibrating mesh nebulizers delivered > 2-fold more radiolabeled drug into the respiratory tract compared with conventional jet nebulizers. Additional studies are recommended in subjects with asthma, COPD, bronchiectasis, and cystic fibrosis to better understand differences in both aerosol delivery and response. (ClinicalTrials.gov registration NCT01889524.). |
| File Format |
HTM / HTML |
| ISSN |
00201324 |
| e-ISSN |
19433654 |
| Journal |
Respiratory Care |
| Issue Number |
9 |
| Volume Number |
60 |
| Language |
English |
| Publisher |
The Journal Respiratory Care Company |
| Publisher Date |
2015-09-01 |
| Publisher Place |
United States |
| Access Restriction |
Open |
| Subject Keyword |
Discipline Pulmonary Medicine Nebulizers And Vaporizers Noninvasive Ventilation Instrumentation Radiopharmaceuticals Administration & Dosage Technetium Tc 99m Pentetate Aerosols Cross-over Studies Healthy Volunteers Lung Drug Effects Randomized Controlled Trial |
| Content Type |
Text |
| Resource Type |
Article |
| Subject |
Pulmonary and Respiratory Medicine Critical Care and Intensive Care Medicine |
