Aerosol Delivery During High Frequency Jet Ventilation: An MRI Evaluation

作者：Sood Beena G^*; Latif Zahid; Shen Yimin; Galli Robert J; Dunlap Charles W; Gelmini Matthew J; Haacke E Mark

来源：Respiratory Care, 2012, 57(11): 1901-1907.

DOI：10.4187/respcare.01746

• aerosol
• drug delivery
• gadopentetate dimeglumine
• assisted ventilation
• conventional mechanical ventilation
• high frequency oscillatory ventilation
• high frequency jet ventilation
• magnetic resonance imaging
• jet nebulizer
• neonatal

BACKGROUND: We have previously demonstrated aerosol delivery during conventional and high frequency oscillatory (HFOV) ventilation using magnetic resonance imaging (MRI) in piglets. There are no reports on aerosol delivery during high frequency jet ventilation (HFJV). OBJECTIVE: To compare delivery of aerosolized gadopentetate dimeglumine (Gd-DTPA) in 3 neonatal ventilator circuits: conventional mechanical ventilation, HFOV, and HFJV. METHODS: Aerosols of GdDTPA (0.025 mol/L) generated using a jet nebulizer placed in the inspiratory limb of each ventilator were delivered into an in vitro lung model simultaneously. Multi-slice T1-weighted spin-echo sequence scans were obtained prior to and after 10 and 20 min of cumulative aerosol delivery. Gd-DTPA concentration was calculated from signal intensity changes, and the total amount of Gd-DTPA was estimated. RESULTS: Gd-DTPA was visualized in the lung model at 10 and 20 min for all 3 ventilators. Gd-DTPA delivery was highest with conventional mechanical ventilation (1.92 mu mol at 10 min, 2.89 mu mol at 20 min), followed by HFJV (1.59 mu mol at 10 min, 1.98 mu mol at 20 min) and HFOV (0.79 mu mol at 10 min, 1.00 mu mol at 20 min). CONCLUSIONS: This is the first report of effective aerosol delivery in a neonatal HFJV circuit. Future studies are needed for more accurate quantification of aerosol deposition.

• 出版日期2012-11