In vitro aerosol delivery by vibrating mesh nebulizer (VMN) and pressurized metered dose inhaler (pMDI) using spacers in comparison with T adapters in mechanical ventilation.

Abstract

In vitro performance of spacers were evaluated in comparison with T adapters in adult and paediatric mechanical ventilation models. With the ventilator set in volume controlled (VC) mode with adult breathing parameters, aerosol delivery by pMDI (Ventolin, GSK) was compared when using a spacer (CombiHaler®, Laboratoire optimHal-ProtecSom; Aerochamber MV®, AeroVent® and Aerochamber Mini®, Trudell Medical) instead of a T adapter (Intersurgical). Aerosol delivery by nebulization was compared when using a spacer instead of a T adapter (Aeroneb Solo® T piece, Aerogen).With the ventilator set in VC mode with peadiatric breathing parameters (corresponding to a child of 15kg weight), aerosol delivery by pMDI was compared when using a spacer (MinimHal®, Laboratoire OptimHal-ProtecSom) instead of a MDI adapter (Intersurgical) and aerosol delivery by nebulization was compared when using a spacer (MinimHal®) instead of a T adapter (Aeroneb Solo® peadiatric T piece). Using the adult model, Aerosol delivery by nebulization increased when using the spacer (42.75 ± 4.48 % vs 35.26 ± 7.44 %). Aerosol delivery by pMDI increased up to two or three-fold when using the spacer instead of an MDI adapter.Using the peadiatric model, aerosol delivery by nebulization was higher with the spacer than with the T piece (23.84 ± 7.72 % 15.06 ± 4.18 %). Aerosol delivery by pMDI increased by up to three-fold when using the spacer in comparison to the T adapter (9.45 ± 2.27 % vs 2.94 ± 0.34%). In this in vitro study, using a spacer instead of a T adapter with both a pMDI and a VMN increased drug delivery.