The delivery of therapeutic aerosols through endotracheal tubes
- 1 January 1986
- journal article
- research article
- Published by Wiley in Pediatric Pulmonology
- Vol. 2 (1) , 19-26
- https://doi.org/10.1002/ppul.1950020108
Abstract
We used an in vitro model system to examine the sites of deposition of aqueous therapeutic aerosols administered through 3-mm, 6-mm, and 9-mm endotracheal tubes (commonly used in infants, children, and adults) at clinically relevant inspiratory flow rates. Aerosol was delivered to the endotracheal tube via a “T” piece and a 90° elbow. Aerosol exiting the endotracheal tube passed through an appropriately sized Plexiglas model of the trachea and mainstem bronchi, and then into an 80-liter bag. Aerosol deposited in the “T” and elbow, endotracheal tube, large airway model, and collection bag was quantitated separately using 0.1% uranine as a tracer. Study of a conventional aerosol typical of those in common clinical use (aerodynamic mass median diameter = 3.95 μm) showed that most of the aerosol delivered into each endotracheal tube was deposited before leaving the mainstem bronchi. Substitution of an alternative nebulizer that produced a much smaller aerosol particle size (aerodynamic mass median diameter = 0.54 μm) dramatically decreased aerosol deposition in the “T” and elbow, endotracheal tube, and large airway model, and increased the quantity of aerosol penetrating beyond the mainstem bronchi up to ninefold. The mass median particle diameter of the conventional aerosol was reduced during endotracheal tube and large airway passage by poorly defined aerodynamic mechanisms that selectively removed larger particles. The smaller submicron aerosol was not similarly affected. Thus, conventional therapeutic aerosols appear to penetrate poorly through endotracheal tubes. Use of smaller particle size aerosols in treatment of intubated patients may be an effective way to circumvent this problem.Keywords
This publication has 10 references indexed in Scilit:
- Antiviral Chemotherapy and ChemoprophylaxisScience, 1985
- Aerosol delivery in intubated, mechanically ventilated patientsCritical Care Medicine, 1985
- Ultrasonic and Jet Aerosolization of Phospholipids and the Effects on Surface ActivityPediatric Research, 1983
- ASSESSMENT OF JET NEBULISERS FOR LUNG AEROSOL THERAPYThe Lancet, 1983
- Aerosolized Ribavirin Treatment of Infants with Respiratory Syncytial Viral InfectionNew England Journal of Medicine, 1983
- Particle Size Distribution and Deposition from a Jet Nebuliser: Influence of Humidity and TemperatureClinical Science, 1982
- RIBAVIRIN SMALL-PARTICLE AEROSOL TREATMENT OF INFLUENZAThe Lancet, 1981
- Response of asthmatic patients to fenoterol inhalation: A method of quantifying the airway bronchodilator doseClinical Pharmacology & Therapeutics, 1978
- Comparison of intravenous and nebulised salbutamol in initial treatment of severe asthma.BMJ, 1978