DiBlasi's full paper on the AeroChamber mini Chamber recently published in April of Respiratory Care
Click HERE to be taken the April issue of Respiratory Care. See below for the abstract published back in November 2009.
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A Novel Versatile Valved Holding Chamber for Delivering Inhaled Medications to Neonates and Small Children: Laboratory Simulation of Delivery Options
BACKGROUND: Delivery of bronchodilators to infants and small children by pressurized metered-dose inhaler-holding aerosol valved holding chamber (pMDI-VHC) is limited by airway narrowness, short respiratory cycle times, and low tidal volumes. There is a need for a versatile, efficient VHC, given the variety of treatment modalities. Experiments with such a VHC were undertaken to answer the question: “Are differences in the delivery of inhaled beta2-agonist medication associated with the simulated delivery options”:
- mechanical ventilation (MV) via endotracheal tube (ETT);
- manual resuscitation (MR) via ETT;
- spontaneous breathing (SB) via face mask?
METHODS: VHCs with internal geometry optimized for aerosol delivery and capable of accepting GSK pMDI canisters with dose counter (AeroChamber mini™, n=5 devices/test) were evaluated for the delivery of HFA-albuterol (90 µg/actuation). Tidal breathing of a premature neonate with tidal volume (6-ml), designated NEO-P; term neonate with tidal volume (20-ml), designated NEO-T; and a small child (-2 year) with tidal volume (60-ml), designated CH-S, were simulated. Aerosol collection was obtained by electret filter with quantitative assay for albuterol.
RESULTS: Total emitted mass albuterol/actuation (TEM) ex VHC was marginally greater for the SB (12.1 ± l.8µg) than the MR (10.0 ± 1.1 µg) child model (p=0.046. Albuterol delivery by MV, through measureable and comparable for each model (3.3 ± l.2 µg NEO-P; 3.8 ± 2.1 µg NEO-T; 4.2 ± 2.3 µg CH-S (p = 0.63), was significantly lower than via the other simulated delivery options (p<0.001). Similar TEM was measured for the SB (6.0 ± 1.0 µg NEO-P; 10.5 ±0.7 µg NEO-T), or MR (5.5 ± 0.3 µg NEO-P; 10.7 ± 0.9 µg NEO-T) neonate (1-way ANOVA, p ≥ 0.46).
DISCUSSION AND CONCLUSION: Reduced delivery of medication for MV was likely associated with the saturated atmosphere within the breathing circuit (T = 37°C/>99%RH) compared with conditions (T = 22 ± 1°C/44 ± 7% RH) for the other modalities. The new VHC may provide a versatile alternative to existing devices designed exclusively for each treatment modality.