Nebulizer Article
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Questions and Answers

Which variables influence the effectiveness of aerosol drug delivery during mechanical ventilation?

  • Patient's age and gender
  • Nebulizer type and position on the ventilator circuit (correct)
  • Ventilator brand and model
  • Humidity level in the patient's room

What was nebulized in the study to determine the influence of nebulizer position and bias flow?

  • Saline solution
  • Albuterol sulfate (2.5 mg) (correct)
  • Corticosteroids
  • Sterile water

Where was the jet nebulizer placed in the second nebulizer position?

  • Positioned at an inlet to the humidifier
  • Before the heated humidifier with 15 cm of large-bore tubing (correct)
  • 15 cm from the Y-piece adapter
  • Directly attached to the Y-piece

What was used as simulated models in the study?

<p>Simulated pediatric and adult lung models (B)</p> Signup and view all the answers

Which factors had not been established for different age populations according to the article?

<p>Impact of nebulizer type, position, and bias flow on aerosol drug delivery (B)</p> Signup and view all the answers

What is the main objective of this study?

<p>To evaluate the influence of nebulizer position and bias flow on aerosol drug delivery (D)</p> Signup and view all the answers

What is the effect of nebulizer placement on drug delivery according to the study?

<p>Nebulizer placement prior to the humidifier increased drug delivery with both the jet nebulizer and the vibrating-mesh nebulizer, with a greater increase with the jet nebulizer. (D)</p> Signup and view all the answers

Which type of nebulizer provided higher efficiency when placed proximal to the ventilator during simulated adult mechanical ventilation, according to the study?

<p>Jet nebulizers (C)</p> Signup and view all the answers

What factor greatly influences aerosol drug delivery in mechanically ventilated adults, as reported in the study?

<p>Peak inspiratory flow (A)</p> Signup and view all the answers

What impact did higher bias flow have on drug delivery during simulated mechanical ventilation in both lung models?

<p>Higher bias flow reduced drug delivery. (A)</p> Signup and view all the answers

What was the inner-diameter of the endotracheal tubes used for the adult and pediatric lung models, respectively?

<p>8-mm for adult and 5-mm for pediatric lung models (A)</p> Signup and view all the answers

What method was used to analyze albuterol sulfate in the study?

<p>Spectrophotometry (D)</p> Signup and view all the answers

What is a key factor that influences aerosol drug deposition in intubated and mechanically ventilated patients, according to the study?

<p>Physical properties of the drug (A)</p> Signup and view all the answers

Which factor differentiates aerosol delivery efficiency according to previous studies mentioned in the text?

<p>Residual drug volume (D)</p> Signup and view all the answers

What did Hughes and Saez find regarding nebulizer placement influencing aerosol drug delivery during mechanical ventilation?

<p>Moving the nebulizer back to the manifold position doubled the aerosol drug delivery during mechanical ventilation, compared to nebulizer placement at the Y-piece. (C)</p> Signup and view all the answers

What did recent studies compare regarding aerosol drug delivery efficiency during simulated adult mechanical ventilation?

<p>They compared efficiency across different types of nebulizers and various positions. (D)</p> Signup and view all the answers

In the study, which type of nebulizer consistently delivered more drug than the other?

<p>Vibrating-mesh nebulizer (A)</p> Signup and view all the answers

What was the impact of bias flow on aerosol delivery according to the findings of the study?

<p>Decrease in drug delivery with increasing bias flow (C)</p> Signup and view all the answers

What was the difference in aerosol delivery between position 1 and position 2 with the pediatric model using a jet nebulizer?

<p>Similar delivery at both positions (A)</p> Signup and view all the answers

Why did the vibrating-mesh nebulizer deliver less drug when positioned at the ventilator in a previous study?

<p>Greater internal volume of the circuit and humidifier chamber (C)</p> Signup and view all the answers

What was the effect of bias flow on aerosol delivery with the vibrating-mesh nebulizer in the adult circuit?

<p>Increased drug delivery with increasing bias flow (C)</p> Signup and view all the answers

What was the impact of bias flow on aerosol delivery with the jet nebulizer in the adult circuit?

<p>Decrease in drug delivery with increasing bias flow (C)</p> Signup and view all the answers

What was the difference in aerosol delivery between position 2 and position 1 with the adult model using a vibrating-mesh nebulizer?

<p>Increased delivery at position 2 (B)</p> Signup and view all the answers

What was the impact of bias flow on aerosol delivery with the jet nebulizer in the pediatric circuit?

<p>No impact on drug delivery (B)</p> Signup and view all the answers

What was the difference in aerosol delivery between the adult and pediatric models at position 2 using a jet nebulizer?

<p>Similar delivery in both models (D)</p> Signup and view all the answers

What was found to be consistent across both adult and pediatric models according to the study findings?

<p>Similar aerosol delivery with both nebulizer types (C)</p> Signup and view all the answers

What was speculated as a possible reason for reduced drug delivery when a vibrating-mesh nebulizer was positioned at the ventilator?

<p>Lack of aerosol reservoir effect (A)</p> Signup and view all the answers

What is one of the findings of greatest clinical relevance according to the study?

<p>Minor impact on efficacy or patient safety due to bias flow (C)</p> Signup and view all the answers

What can reduce aerosol delivery by up to 50% compared to ventilation under ambient conditions with anhydrous gas mixtures?

<p>Heating and humidifying the circuit gas (B)</p> Signup and view all the answers

What is the purpose of continuous bias flow through the ventilator circuit?

<p>To reduce patient work of breathing (C)</p> Signup and view all the answers

Which factor reduces aerosol delivery efficiency in infants and small children compared to adults?

<p>Differences in anatomical proportion (C)</p> Signup and view all the answers

What did the study aim to determine the influence of during simulated mechanical ventilation of pediatric and adult patients?

<p>Bias flow, nebulizer type, and position on aerosol drug delivery (C)</p> Signup and view all the answers

What is the purpose of maintaining the natural curve of the endotracheal tube (ETT) during ventilation?

<p>To prevent condensate or liquid medication from reaching the filter media (B)</p> Signup and view all the answers

Which nebulizer uses pressurized gas to form a jet passing over a capillary tube that draws liquid formulation into the jet stream to produce aerosol?

<p>Misty Finity (Cardinal Health, Dublin, Ohio) (C)</p> Signup and view all the answers

Which device uses electricity to vibrate an aperture plate at 128 kHz to produce aerosol?

<p>AeroNeb Solo (Aerogen, Mountain View, California) (D)</p> Signup and view all the answers

What was the compliance of the test lung set to simulate a mechanically ventilated adult or small pediatric patient?

<p>$0.1 L/cm H2O$ (B)</p> Signup and view all the answers

What is the main advantage of the vibrating-mesh nebulizer over the jet nebulizer?

<p>Higher drug delivery efficiency (C)</p> Signup and view all the answers

In the study, how did the vibrating-mesh nebulizer compare to the jet nebulizer in terms of aerosol delivery?

<p>Vibrating-mesh nebulizer delivered 2–4 times more aerosol than the jet nebulizer (C)</p> Signup and view all the answers

At which position in the ventilator circuit was the vibrating-mesh nebulizer more efficient?

<p>Position 2 for both adult and pediatric models (C)</p> Signup and view all the answers

How did the bias flow affect aerosol drug delivery with the jet nebulizer?

<p>Higher bias flow decreased aerosol drug delivery (C)</p> Signup and view all the answers

What was used to determine the albuterol concentration in the experiments?

<p>Spectrophotometry (C)</p> Signup and view all the answers

What was the residual drug volume for the vibrating-mesh nebulizer?

<p>0.1–0.3 mL (B)</p> Signup and view all the answers

How many times was each experiment run in the study?

<p>3 (A)</p> Signup and view all the answers

What was used to collect the inhaled mass of albuterol sulfate?

<p>Absolute filter at the distal tip of the ETT (C)</p> Signup and view all the answers

What is the potential benefit of placing the nebulizer proximal to the ventilator?

<p>Reducing the risk of bacterial contamination in the inspiratory limb (B)</p> Signup and view all the answers

What raises a concern with the heating of medication in the heated humidifier reservoir?

<p>Formation of hazardous vapors at ⱖ 70°C (A)</p> Signup and view all the answers

What is a limitation of the study's results?

<p>Deposited dose reflecting the amount of inhaled aerosol exhaled in vivo (A)</p> Signup and view all the answers

What is a factor that greatly influences aerosol drug delivery during mechanical ventilation, according to the study?

<p>The type of nebulizer used (C)</p> Signup and view all the answers

What did Moraine and co-workers find regarding ipratropium in mechanically ventilated adult patients after 500 ␮g via nebulizer?

<p>No difference in ipratropium in urine based on nebulizer placement (B)</p> Signup and view all the answers

What does reducing the risk of nebulizers with lower residual volume depositing greater volumes of liquid in the inspiratory limb help prevent?

<p>Occlusion of the airway by condensate (D)</p> Signup and view all the answers

What is a potential benefit of isolating the aerosol generator from retrograde contamination?

<p>Reduction in liquid condensate load in the circuit (A)</p> Signup and view all the answers

What does higher bias flow decrease in models of adult and pediatric mechanical ventilation?

<p>Aerosol drug delivery from jet nebulizers (A)</p> Signup and view all the answers

What is a potential concern regarding drugs heated at ⱖ 70°C for extended periods?

<p>Reduced stability and potential formation of hazardous vapors (B)</p> Signup and view all the answers
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