Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1995 Jan;50(1):50–53. doi: 10.1136/thx.50.1.50

Effect of a spacer on pulmonary aerosol deposition from a jet nebuliser during mechanical ventilation.

C J Harvey 1, M J O'Doherty 1, C J Page 1, S H Thomas 1, T O Nunan 1, D F Treacher 1
PMCID: PMC473707  PMID: 7886649

Abstract

BACKGROUND--Several factors have been identified which improve nebulised aerosol delivery in vitro. One of these is the addition of a spacer to the ventilator circuit which improves aerosol delivery from a jet nebuliser to a model lung by approximately 30%. The current study was designed to demonstrate whether similar improvements could be demonstrated in vivo. METHODS--Ten patients (seven men) were studied during mechanical ventilation (Siemens Servo 900C) after open heart surgery. Aerosol was delivered using a Siemens Servo 945 nebuliser system (high setting) driving a System 22 Acorn jet nebuliser (Medic-Aid) containing 3 ml technetium-99m labelled human serum albumin (99mTc-HSA (50 micrograms); activity in the first nebulisation, 90 MBq; in the second nebulisation, 185 MBq). Central and peripheral lung aerosol deposition and the time to complete deposition were measured using a gamma camera and compared when the nebuliser was connected to the inspiratory limb using a simple T-piece or a 600 ml spacer. RESULTS--The addition of the spacer increased total lung deposition (mean (SD) percentage initial nebuliser activity) from 2.2 (0.7)% to 3 (0.8)%. There was no difference in the time required to complete nebulisation (18.2 min v 18.3 min respectively for T-piece and spacer) or in the retention of activity in the nebuliser (46.2% v 47.1% respectively). CONCLUSIONS--The combination of a spacer with a jet nebuliser increased lung deposition by 36% in mechanically ventilated patients and is a simple way of increasing drug deposition or reducing the amount of an expensive drug required for nebulisation.

Full text

PDF
50

Images in this article

51Image
on p.51

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Fuller H. D., Dolovich M. B., Posmituck G., Pack W. W., Newhouse M. T. Pressurized aerosol versus jet aerosol delivery to mechanically ventilated patients. Comparison of dose to the lungs. Am Rev Respir Dis. 1990 Feb;141(2):440–444. doi: 10.1164/ajrccm/141.2.440. [DOI] [PubMed] [Google Scholar]
  2. MacIntyre N. R., Silver R. M., Miller C. W., Schuler F., Coleman R. E. Aerosol delivery in intubated, mechanically ventilated patients. Crit Care Med. 1985 Feb;13(2):81–84. doi: 10.1097/00003246-198502000-00005. [DOI] [PubMed] [Google Scholar]
  3. Newman S. P., Millar A. B., Lennard-Jones T. R., Morén F., Clarke S. W. Improvement of pressurised aerosol deposition with Nebuhaler spacer device. Thorax. 1984 Dec;39(12):935–941. doi: 10.1136/thx.39.12.935. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Newman S. P., Morén F., Pavia D., Little F., Clarke S. W. Deposition of pressurized suspension aerosols inhaled through extension devices. Am Rev Respir Dis. 1981 Sep;124(3):317–320. doi: 10.1164/arrd.1981.124.3.317. [DOI] [PubMed] [Google Scholar]
  5. O'Doherty M. J., Thomas S. H., Page C. J., Treacher D. F., Nunan T. O. Delivery of a nebulized aerosol to a lung model during mechanical ventilation. Effect of ventilator settings and nebulizer type, position, and volume of fill. Am Rev Respir Dis. 1992 Aug;146(2):383–388. doi: 10.1164/ajrccm/146.2.383. [DOI] [PubMed] [Google Scholar]
  6. O'Riordan T. G., Greco M. J., Perry R. J., Smaldone G. C. Nebulizer function during mechanical ventilation. Am Rev Respir Dis. 1992 May;145(5):1117–1122. doi: 10.1164/ajrccm/145.5.1117. [DOI] [PubMed] [Google Scholar]
  7. O'Riordan T. G., Palmer L. B., Smaldone G. C. Aerosol deposition in mechanically ventilated patients. Optimizing nebulizer delivery. Am J Respir Crit Care Med. 1994 Jan;149(1):214–219. doi: 10.1164/ajrccm.149.1.8111585. [DOI] [PubMed] [Google Scholar]
  8. Thomas S. H., Langford J. A., George R. D., Geddes D. M. Improving the efficiency of drug administration with jet nebulisers. Lancet. 1988 Jan 16;1(8577):126–126. doi: 10.1016/s0140-6736(88)90331-5. [DOI] [PubMed] [Google Scholar]
  9. Thomas S. H., O'Doherty M. J., Fidler H. M., Page C. J., Treacher D. F., Nunan T. O. Pulmonary deposition of a nebulised aerosol during mechanical ventilation. Thorax. 1993 Feb;48(2):154–159. doi: 10.1136/thx.48.2.154. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Thomas S. H., O'Doherty M. J., Page C. J., Treacher D. F., Nunan T. O. Delivery of ultrasonic nebulized aerosols to a lung model during mechanical ventilation. Am Rev Respir Dis. 1993 Oct;148(4 Pt 1):872–877. doi: 10.1164/ajrccm/148.4_Pt_1.872. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES