Abstract
Background & Objectives: Supplemental oxygen and
aerosol therapy may be used in combination as a treatment for neonates
suffering from hypoxemia caused by respiratory diseases. Due to cost and
lack of availability of oxygen cylinders in some countries, oxygen
concentrators are a reported substitute. This study was designed to
determine whether using an oxygen concentrator and low-flow oxygen
therapy impacts aerosol drug delivery in a simulated spontaneously
breathing neonate patient. Methods: A vibrating mesh
nebuliser (VMN; Aerogen Solo) was used to aerosolise a 500µL dose of
salbutamol. The aerosol was delivered via a nasal cannula to a neonate
head model in combination with oxygen concentrator at gas flow rates of
0.2, 1.0 and 5.0 LPM and low-flow oxygen therapy at gas flow rates of
1.0, 4.0 and 5.0 LPM. The mass of drug in terms of emitted and tracheal
doses were recorded. The impact of VMN operation and refill on circuit
pressure in both systems was also measured. Results: The
oxygen concentrator delivered a higher emitted dose than the low flow
system, the largest emitted dose (%) being 20.58 ± 0.50% and 14.69 ±
0.89% respectively at 1.0 LPM , p = 0.018. The largest tracheal dose
(%) was generated with the oxygen concentrator, 11.01 ± 0.29% at
5.0LPM compared to 9.66 ± 1.53% for low-flow oxygen therapy, p = 0.073.
Refill and operation of the VMN did not impact the circuit pressure in
either system. Conclusions: This study shows that the
system used to provide combinational aerosol and supplemental oxygen
therapy has a significant impact on the quantity of nebulised
therapeutic delivered to the patient.