Effect of Nebulizer Type and Position on Aerosol Drug Delivery during Support Mechanical Ventilation and Spontaneously Breathing for Tracheostomized Adult Patients

Patrick M. Kelly, Andrew O’Sullivan, Cathy McKenna, Louise Sweeney & Ronan MacLoughlin


In tracheostomized patients the effect of nebulizer type/platform has not been studied in great detail. This study investigated tracheal dose delivery for a vibrating mesh nebulizer (VMN) and jet nebulizer (JN) in support (single limb) mechanical ventilation (SMV) and spontaneously breathing (SB) tracheostomized patients. Selection of nebulizer type can have a substantial influence when treating a patient, earlier studies have shown that the VMN provides more aerosol than the conventional JN [1]. The nebulizer was placed at two positions during the SMV, 1) Dry side of the humidifier pot and 2) at tracheostomy tube (no spacers were used between the nebulizer t-piece and tracheostomy tube) and at the tracheostomy tube for SB. Results: the VMN delivered significantly greater % aerosol delivery when compared to the JN across all positions evaluated. The VMN proximal to tracheostomy tube during SMV facilitated the highest tracheal dose (50.78 ± 2.65%) compared with JN (15.89 ± 1.41%) at this position. Conclusion: the VMN delivered a significantly larger fraction of aerosol (P-values <0.05) when compared to the JN for the tracheal dose for all positions evaluated for SMV and SB in tracheostomy patients.

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