Evaluation of a prototype expiratory-phase aerosol controller during simulated pediatric volume-controlled...

Area of Science:

• Respiratory care
• Biomedical engineering
• Pharmacology

Background:

• Mechanical ventilation often requires adjusting settings for aerosol delivery.
• Inadvertent tidal volume (VT) increases can occur with certain nebulization methods.
• An expiratory-phase aerosol controller (EXPAC) was developed to address these challenges.

Purpose of the Study:

• To evaluate aerosol delivery differences between EXPAC and continuous nebulization.
• To assess the impact of EXPAC on tidal volume (VT) in pediatric and neonatal circuits.
• To compare aerosol delivery with different nebulizer supply line lengths (30 cm vs. 213 cm).

Main Methods:

• Bench evaluation of an electrically powered EXPAC integrated with a VIP Bird ventilator.
• Measurement of tidal volume (VT) at the patient connection under various conditions (no nebulizer, EXPAC with 30cm/213cm lines).
• Quantification of aerosol delivery using filter weight differences at the patient connection.

Main Results:

• EXPAC with a 30cm line did not significantly alter VT compared to no nebulizer.
• A significant VT increase (p=0.0001) was observed with the 213cm supply line.
• Aerosol delivery with EXPAC was comparable to continuous nebulization in both pediatric (1.5% vs 1.7%) and neonatal (1.6% vs 1.5%) circuits.

Conclusions:

• EXPAC eliminates the need to adjust ventilator settings during aerosol administration.
• The device demonstrated equivalent aerosol delivery efficacy to continuous nebulization.
• EXPAC offers a viable alternative for aerosolized medication delivery in mechanically ventilated patients.