Abstract :Introduction: The aim of this study was to evaluate the efficiency of aerosol devices in a simulated adult lung model using different NIV masks.
Methods: A ventilator with NIV circuit was attached via face mask to a manikin with a collecting filter at the level of the bronchi attached to a passive test lung. Aerosol devices: (1) Jet Nebulizer (JN); (2) Vibrating Mesh Nebulizer (VMN) and (3) Pressurized metered-dose inhaler (pMDI), were placed between the leak port and mask. NIV with PIP/PEEP of 20/5 cmH2O was used with full face mask, oro-nasal mask, and Performa track mask (Philips, Murrysville, PA). Albuterol sulfate (2.5 mg/3 ml) was nebulized with JN and VMN. Fourpuffs from a pMDI (108 µg/puff) were emitted into a spacer (Aerovent, Monaghan/Trudell) in recommended and reverse orientation (n=3). Drug was eluted from filters and analyzed by UV/Spec at 276 nm. Inhaled mass and percent of nominal/ emitted dose were quantified. Descriptive statistics, Kruskal Wallis analysis of variance, and Mann- Whitney U tests were used for data analysis.
Results: During NIV, inhaled mass percent ranged from 13.12% ± 0.72% to 28.83% ± 1.93% across devices. VMN had greater inhaled mass than JN (p=0.0001). Efficiency of pMDI was similar with both orientations (p=0.253). Both Solo and NIVO were more efficient with oro-nasal mask than full face mask (p=0.012 and p=0.037, respectively.)
Conclusion: The efficiency of aerosol devices and masks during NIV varied in this simulated adult lung model. The JN was less efficient than either VMN or pMDI with spacer.