A comparison of Aerosol Delivery across two High Flow Therapy interfaces: Nasal Cannula and Tracheostomy Tube

A comparison of Aerosol Delivery across two High Flow Therapy interfaces: Nasal Cannula and Tracheostomy Tube

Sorcha Murphy, Mary Joyce, Gavin Bennett, Ian MacDonnacha, Louise Sweeney & Ronan Mac Loughlin

Aerogen, IDA Business Park, Dangan, Galway, Ireland

Summary

During periods of weaning from full ventilatory support, the patient can be stepped down from invasive mechanical ventilation to less invasive means of ventilatory support, such as high flow therapy. Whilst high flow therapy is synonymous with the use of nasal cannula, tracheostomy tubes are also used. To date there has been no direct comparison of the effect these two interfaces have on aerosol therapy during high flow therapy. In this study, aerosol performance was characterised across a range of clinically relevant gas flow rates, in combination with both adult and paediatric patient models, for nasal cannula and tracheostomy tube. Following testing it was seen that increasing high flow gas flow rate was seen to reduce the tracheal dose. For all test combinations across adult and paediatric, and gas flow rates, tracheostomy tubes were seen to facilitate significantly higher doses than nasal cannula.

 

LPM

% Tracheal Dose

Adult  Nasal Cannula

Adult Tracheostomy Tube

Paediatric Nasal Cannula

Paediatric Tracheostomy Tube

10

19.81

29.30

7.48

14.90

25

N/A

N/A

3.52

6.48

60

1.86

3.67

N/A

N/A

Table 1 – Average ± Standard Deviation values of % tracheal dose for a spontaneously breathing adult and paediatric with a nasal cannula and a tracheostomy tube during high flow therapy.

For the first time, we have highlighted the potential for tracheostomy tubes, used in combination with high flow therapy for facilitating greater aerosol delivery than nasal cannula. These findings may have important consequences in the choice of high flow therapy interface used during weaning from mechanical ventilation.

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