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Intubation-mediated Intratracheal (IMIT) Instillation: A Noninvasive, Lung-specific Delivery System
Published on: November 17, 2014
Aerosol delivery through tracheostomy tubes: an in vitro study.
L Pitance1, L Vecellio, G Delval
1Oral and Maxillofacial Surgery Unit, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium.
Journal of Aerosol Medicine and Pulmonary Drug Delivery
|June 14, 2012
Summary
Removing the inner tracheostomy cannula and using an unvented nebulizer with corrugated tubing increases amikacin respiratory dose. This optimizes drug delivery for patients requiring nebulization via tracheostomy tube.
Area of Science:
- Respiratory Medicine
- Pharmacology
- Biomedical Engineering
Background:
- Investigated amikacin delivery via tracheostomy tube.
- Assessed impact of cannula inner diameter (ID) and removal.
- Evaluated three jet nebulizer configurations (vented, unvented with tubing, unvented).
Purpose of the Study:
- Determine optimal nebulizer settings for amikacin delivery.
- Quantify aerosol loss within tracheostomy cannulas.
- Evaluate effect of cannula removal on respiratory drug dose.
Main Methods:
- Used a lung model simulating spontaneous breathing.
- Measured inhaled and respiratory doses of amikacin.
- Tested various cannula IDs (6.5-10 mm) and nebulizer types.
Main Results:
- Respiratory dose ranged from 44±3 mg to 96±1 mg.
- Aerosol loss in cannula reached up to 63% of inhaled dose.
- Smaller cannula ID correlated with greater aerosol loss.
Conclusions:
- Removing inner tracheostomy cannula significantly increases respiratory drug dose (up to 31.3%).
- Unvented nebulizer with corrugated tubing (N2) yielded higher respiratory doses.
- Recommend removing inner cannula and using N2 for improved amikacin nebulization.
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