NEW AEROSOL DELIVERY SYSTEM FOR NEONATAL VENTILATOR CIRCUITS
NEW AEROSOL DELIVERY SYSTEM FOR NEONATAL VENTILATOR CIRCUITS
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DOI：
10.1136/adc.67.7_spec_no.826
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发表时间：
1992-07-01
影响因子：
4.4
通讯作者：
MILNER, AD
中科院分区：
文献类型：
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作者：
EVERARD, ML;STAMMERS, J;MILNER, AD
越来越多的证据表明，以气溶胶形式输送的各种药物可能对新生儿病房有益。为了避免与在呼吸机回路中使用喷射雾化器有关的许多问题，设计了一个与计量吸入器（MDI）结合使用的腔室。尺寸（4厘米x11厘米）的选择是为了最大限度地提高药物输送。随后进行体外研究，以确定最佳操作条件。通过该系统输送的甘糖酸钠被收集在放置在气管内管尖端和模型肺之间的过滤器上。用紫外分光光度法测定给药剂量。使用德尔格Babylog 8000呼吸机时，发现在吸气周期之前，当腔室放置在气管内管附近时，通过使用较长的（一秒）吸气时间，使药物输送最大化。在这些条件下，原始剂量的1.5-2%以11-22毫升的潮汐量沉积在过滤器上。如果考虑到体重，这是MDI给成人的等效剂量的许多倍。使用放射性标记的气溶胶确认了有效的药物输送到过滤器。放射性标记研究将气溶胶输送到插管兔的肺中，表明当校正每个肺叶的重量时，沉积的气溶胶在肺叶之间均匀分布。综上所述，该装置似乎可以将大量可重复的药物输送到下呼吸道，同时使用简单。
There is mounting evidence that a variety of drugs delivered as aerosols are likely to be of benefit in neonatal units. To avoid many of the problems associated with the use of jet nebulisers in ventilator circuits, a chamber was designed to be used in conjunction with a metered dose inhaler (MDI). The dimensions (4 cmX11 cm) were chosen in an attempt to maximise drug delivery. In vitro studies were subsequently performed in order to determine the optimum operating conditions. Sodium cromoglycate delivered via this system was collected on a filter placed between the tip of an endotracheal tube and a model lung. The dose delivered was determined by means of an ultraviolet spectrophotometric assay. Using a Draeger Babylog 8000 ventilator it was found that drug delivery as maximised by actuating the device just before the inspiratory cycle when the chamber was placed adjacent to the endotracheal tube and by using a long (one second) inspiratory time. Under these conditions 1.5-2% of the original dose was deposited upon the filter at tidal volumes of 11-22 ml. When considered in terms of body weight this is many times the equivalent dose delivered to adults from an MDI. Effective drug delivery to the filter was confirmed using a radiolabelled aerosol. Radiolabelled studies delivering aerosol to the lungs of intubated rabbits demonstrated that deposition aerosol was distributed uniformly between lobes when corrected for the weight of each lobe.In conclusion, the device appears likely to deliver significant, reproducible quantities of drug to the lower respiratory tract while being simple to use.