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In Vitro Determination of the Main Effects in the Design of High-Flow Nasal Therapy Systems with Respect to Aerosol Performance
Introduction The use of concurrent aerosol delivery during high-flow nasal therapy (HFNT) may be exploited to facilitate the delivery of a variety of prescribed medications for inhalation. Until now, a systematic approach to determine the conditions required to yield an optimal emitted dose has not...
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| Published in: | Pulmonary therapy 2018-06, Vol.4 (1), p.73-86 |
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| creator | Bennett, Gavin Joyce, Mary Sweeney, Louise MacLoughlin, Ronan |
| description | Introduction
The use of concurrent aerosol delivery during high-flow nasal therapy (HFNT) may be exploited to facilitate the delivery of a variety of prescribed medications for inhalation. Until now, a systematic approach to determine the conditions required to yield an optimal emitted dose has not been reported. The aim of this study was to establish the effects of gas flow rate, input droplet size, and nebulizer position on the amount of aerosol exiting the nasal cannula during HFNT and thus becoming available for inhalation.
Methods
Testing was completed according to a factorial statistical design of experiments (DOE) approach. Emitted dose was characterized with a vibrating mesh nebulizer (Aerogen Solo, Aerogen Ltd) for an adult model of HFNT at three clinically relevant gas flow rates, using three nebulizers producing varying input droplet sizes and placed at two different nebulizer positions.
Results
Increasing the gas flow rate significantly lowered the emitted dose, with a dose of 7.10% obtained at 10 LPM, 2.67% at 25 LPM, and 1.30% at 40 LPM (
p |
| doi_str_mv | 10.1007/s41030-018-0054-x |
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| fullrecord | <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_3ecec56b9a6341f5976fae873a8fee74</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_3ecec56b9a6341f5976fae873a8fee74</doaj_id><sourcerecordid>2026813038</sourcerecordid><originalsourceid>FETCH-LOGICAL-c518x-7e1712d969843f0ef76b2f1cc15edb8c021b11996031d3537013a917d00c793a3</originalsourceid><addsrcrecordid>eNp1kk1vEzEQhlcIRKvSH8AFWeLCZcFj79q7F6SqHzRS-RAUrpbjHSeOdtfBdmhy4q_jJCVQJE4ezbzzjD1-i-I50NdAqXwTK6CclhSaktK6KtePimPGRVWCrMTjQ1xXR8VpjAtKKbScVbJ5WhxxRplgVX1c_JyM5JtLwZMLTBgGN-rk_Ei8JWmO5L12I7m0Fk2KJIfb3AVGN9sprt1sXl71_o580FH35HaOQS835MsmJhwiuXNpTj5jXOZ2kjw5w-Cj78knDNaHQY8GnxVPrO4jnt6fJ8XXq8vb8-vy5uO7yfnZTWlqaNalRJDAula0TcUtRSvFlFkwBmrspo2hDKYAbSsoh47XXFLgugXZUWpkyzU_KSZ7buf1Qi2DG3TYKK-d2iV8mCkdkjM9Ko4GTS2mrRa8Alu3UliNjeS6sYiyyqy3e9ZyNR2wMzimoPsH0IeV0c3VzP9QohWScZkBr-4BwX9fYUxqcNFg3-sR_SoqxmtGayZ3s17-I134VRjzqtT2DxvglDdZBXuVyQuOAe3hMkDV1i1q7xaV3aK2blHr3PPi71ccOn57IwvYXhBzaZxh-DP6_9Rf0xPKag</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2026813038</pqid></control><display><type>article</type><title>In Vitro Determination of the Main Effects in the Design of High-Flow Nasal Therapy Systems with Respect to Aerosol Performance</title><source>PubMed (Medline)</source><source>Publicly Available Content Database (Proquest) (PQ_SDU_P3)</source><source>Springer Nature - SpringerLink Journals - Fully Open Access </source><creator>Bennett, Gavin ; Joyce, Mary ; Sweeney, Louise ; MacLoughlin, Ronan</creator><creatorcontrib>Bennett, Gavin ; Joyce, Mary ; Sweeney, Louise ; MacLoughlin, Ronan</creatorcontrib><description>Introduction
The use of concurrent aerosol delivery during high-flow nasal therapy (HFNT) may be exploited to facilitate the delivery of a variety of prescribed medications for inhalation. Until now, a systematic approach to determine the conditions required to yield an optimal emitted dose has not been reported. The aim of this study was to establish the effects of gas flow rate, input droplet size, and nebulizer position on the amount of aerosol exiting the nasal cannula during HFNT and thus becoming available for inhalation.
Methods
Testing was completed according to a factorial statistical design of experiments (DOE) approach. Emitted dose was characterized with a vibrating mesh nebulizer (Aerogen Solo, Aerogen Ltd) for an adult model of HFNT at three clinically relevant gas flow rates, using three nebulizers producing varying input droplet sizes and placed at two different nebulizer positions.
Results
Increasing the gas flow rate significantly lowered the emitted dose, with a dose of 7.10% obtained at 10 LPM, 2.67% at 25 LPM, and 1.30% at 40 LPM (
p
< 0.0001). There was a significant difference in emitted dose between nebulizers with different input droplet sizes, with increasing input droplet size associated with a reduced emitted dose (6.11% with an input droplet size of 3.22 µm, 2.76% with 4.05 µm, and 2.38% with 4.88 µm,
p
= 0.0002, Pearson’s
r
= − 0.2871). In addition, the droplet size exiting the nasal cannula interface was lower than that produced by the aerosol generator for all devices under test. Positioning the nebulizer immediately after the humidification chamber yielded a marginally greater emitted dose (3.79%) than when the nebulizer was placed immediately upstream of the nasal cannula (3.39%). Flow rate, input droplet size, and nebulizer position were at the 0.10 level of significance, indicating that all three factors had significant effects on emitted dose. According to the DOE model, flow rate had the greatest influence on emitted dose, followed by input droplet size and then nebulizer position.
Conclusion
Our findings indicate that in order to optimize the amount of aerosol exiting the nasal cannula interface during HFNT, it is necessary for gas flow rate to be low and the input droplet size to be small, while the nebulizer should be positioned immediately after the humidification chamber.
Funding
Aerogen Limited.</description><identifier>ISSN: 2364-1754</identifier><identifier>EISSN: 2364-1746</identifier><identifier>DOI: 10.1007/s41030-018-0054-x</identifier><identifier>PMID: 32026245</identifier><language>eng</language><publisher>Tarporley: Springer Healthcare Communications</publisher><subject>Aerosol ; Design of experiments ; Droplet size ; Emitted dose ; Family Medicine ; Flow rate ; Gas flow ; General Practice ; High-flow nasal therapy ; Internal Medicine ; Medicine & Public Health ; Original Research ; Pharmacoeconomics and Health Outcomes ; Pharmacotherapy ; Pneumology/Respiratory System ; Quality of Life Research</subject><ispartof>Pulmonary therapy, 2018-06, Vol.4 (1), p.73-86</ispartof><rights>The Author(s) 2018</rights><rights>Pulmonary Therapy is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c518x-7e1712d969843f0ef76b2f1cc15edb8c021b11996031d3537013a917d00c793a3</citedby><cites>FETCH-LOGICAL-c518x-7e1712d969843f0ef76b2f1cc15edb8c021b11996031d3537013a917d00c793a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6967237/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2026813038?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32026245$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bennett, Gavin</creatorcontrib><creatorcontrib>Joyce, Mary</creatorcontrib><creatorcontrib>Sweeney, Louise</creatorcontrib><creatorcontrib>MacLoughlin, Ronan</creatorcontrib><title>In Vitro Determination of the Main Effects in the Design of High-Flow Nasal Therapy Systems with Respect to Aerosol Performance</title><title>Pulmonary therapy</title><addtitle>Pulm Ther</addtitle><addtitle>Pulm Ther</addtitle><description>Introduction
The use of concurrent aerosol delivery during high-flow nasal therapy (HFNT) may be exploited to facilitate the delivery of a variety of prescribed medications for inhalation. Until now, a systematic approach to determine the conditions required to yield an optimal emitted dose has not been reported. The aim of this study was to establish the effects of gas flow rate, input droplet size, and nebulizer position on the amount of aerosol exiting the nasal cannula during HFNT and thus becoming available for inhalation.
Methods
Testing was completed according to a factorial statistical design of experiments (DOE) approach. Emitted dose was characterized with a vibrating mesh nebulizer (Aerogen Solo, Aerogen Ltd) for an adult model of HFNT at three clinically relevant gas flow rates, using three nebulizers producing varying input droplet sizes and placed at two different nebulizer positions.
Results
Increasing the gas flow rate significantly lowered the emitted dose, with a dose of 7.10% obtained at 10 LPM, 2.67% at 25 LPM, and 1.30% at 40 LPM (
p
< 0.0001). There was a significant difference in emitted dose between nebulizers with different input droplet sizes, with increasing input droplet size associated with a reduced emitted dose (6.11% with an input droplet size of 3.22 µm, 2.76% with 4.05 µm, and 2.38% with 4.88 µm,
p
= 0.0002, Pearson’s
r
= − 0.2871). In addition, the droplet size exiting the nasal cannula interface was lower than that produced by the aerosol generator for all devices under test. Positioning the nebulizer immediately after the humidification chamber yielded a marginally greater emitted dose (3.79%) than when the nebulizer was placed immediately upstream of the nasal cannula (3.39%). Flow rate, input droplet size, and nebulizer position were at the 0.10 level of significance, indicating that all three factors had significant effects on emitted dose. According to the DOE model, flow rate had the greatest influence on emitted dose, followed by input droplet size and then nebulizer position.
Conclusion
Our findings indicate that in order to optimize the amount of aerosol exiting the nasal cannula interface during HFNT, it is necessary for gas flow rate to be low and the input droplet size to be small, while the nebulizer should be positioned immediately after the humidification chamber.
Funding
Aerogen Limited.</description><subject>Aerosol</subject><subject>Design of experiments</subject><subject>Droplet size</subject><subject>Emitted dose</subject><subject>Family Medicine</subject><subject>Flow rate</subject><subject>Gas flow</subject><subject>General Practice</subject><subject>High-flow nasal therapy</subject><subject>Internal Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Research</subject><subject>Pharmacoeconomics and Health Outcomes</subject><subject>Pharmacotherapy</subject><subject>Pneumology/Respiratory System</subject><subject>Quality of Life Research</subject><issn>2364-1754</issn><issn>2364-1746</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp1kk1vEzEQhlcIRKvSH8AFWeLCZcFj79q7F6SqHzRS-RAUrpbjHSeOdtfBdmhy4q_jJCVQJE4ezbzzjD1-i-I50NdAqXwTK6CclhSaktK6KtePimPGRVWCrMTjQ1xXR8VpjAtKKbScVbJ5WhxxRplgVX1c_JyM5JtLwZMLTBgGN-rk_Ei8JWmO5L12I7m0Fk2KJIfb3AVGN9sprt1sXl71_o580FH35HaOQS835MsmJhwiuXNpTj5jXOZ2kjw5w-Cj78knDNaHQY8GnxVPrO4jnt6fJ8XXq8vb8-vy5uO7yfnZTWlqaNalRJDAula0TcUtRSvFlFkwBmrspo2hDKYAbSsoh47XXFLgugXZUWpkyzU_KSZ7buf1Qi2DG3TYKK-d2iV8mCkdkjM9Ko4GTS2mrRa8Alu3UliNjeS6sYiyyqy3e9ZyNR2wMzimoPsH0IeV0c3VzP9QohWScZkBr-4BwX9fYUxqcNFg3-sR_SoqxmtGayZ3s17-I134VRjzqtT2DxvglDdZBXuVyQuOAe3hMkDV1i1q7xaV3aK2blHr3PPi71ccOn57IwvYXhBzaZxh-DP6_9Rf0xPKag</recordid><startdate>20180601</startdate><enddate>20180601</enddate><creator>Bennett, Gavin</creator><creator>Joyce, Mary</creator><creator>Sweeney, Louise</creator><creator>MacLoughlin, Ronan</creator><general>Springer Healthcare Communications</general><general>Springer Nature B.V</general><general>Springer Healthcare</general><general>Adis, Springer Healthcare</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>KB0</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PADUT</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20180601</creationdate><title>In Vitro Determination of the Main Effects in the Design of High-Flow Nasal Therapy Systems with Respect to Aerosol Performance</title><author>Bennett, Gavin ; Joyce, Mary ; Sweeney, Louise ; MacLoughlin, Ronan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c518x-7e1712d969843f0ef76b2f1cc15edb8c021b11996031d3537013a917d00c793a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aerosol</topic><topic>Design of experiments</topic><topic>Droplet size</topic><topic>Emitted dose</topic><topic>Family Medicine</topic><topic>Flow rate</topic><topic>Gas flow</topic><topic>General Practice</topic><topic>High-flow nasal therapy</topic><topic>Internal Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Research</topic><topic>Pharmacoeconomics and Health Outcomes</topic><topic>Pharmacotherapy</topic><topic>Pneumology/Respiratory System</topic><topic>Quality of Life Research</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bennett, Gavin</creatorcontrib><creatorcontrib>Joyce, Mary</creatorcontrib><creatorcontrib>Sweeney, Louise</creatorcontrib><creatorcontrib>MacLoughlin, Ronan</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Research Library China</collection><collection>Publicly Available Content Database (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>Pulmonary therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bennett, Gavin</au><au>Joyce, Mary</au><au>Sweeney, Louise</au><au>MacLoughlin, Ronan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>In Vitro Determination of the Main Effects in the Design of High-Flow Nasal Therapy Systems with Respect to Aerosol Performance</atitle><jtitle>Pulmonary therapy</jtitle><stitle>Pulm Ther</stitle><addtitle>Pulm Ther</addtitle><date>2018-06-01</date><risdate>2018</risdate><volume>4</volume><issue>1</issue><spage>73</spage><epage>86</epage><pages>73-86</pages><issn>2364-1754</issn><eissn>2364-1746</eissn><abstract>Introduction
The use of concurrent aerosol delivery during high-flow nasal therapy (HFNT) may be exploited to facilitate the delivery of a variety of prescribed medications for inhalation. Until now, a systematic approach to determine the conditions required to yield an optimal emitted dose has not been reported. The aim of this study was to establish the effects of gas flow rate, input droplet size, and nebulizer position on the amount of aerosol exiting the nasal cannula during HFNT and thus becoming available for inhalation.
Methods
Testing was completed according to a factorial statistical design of experiments (DOE) approach. Emitted dose was characterized with a vibrating mesh nebulizer (Aerogen Solo, Aerogen Ltd) for an adult model of HFNT at three clinically relevant gas flow rates, using three nebulizers producing varying input droplet sizes and placed at two different nebulizer positions.
Results
Increasing the gas flow rate significantly lowered the emitted dose, with a dose of 7.10% obtained at 10 LPM, 2.67% at 25 LPM, and 1.30% at 40 LPM (
p
< 0.0001). There was a significant difference in emitted dose between nebulizers with different input droplet sizes, with increasing input droplet size associated with a reduced emitted dose (6.11% with an input droplet size of 3.22 µm, 2.76% with 4.05 µm, and 2.38% with 4.88 µm,
p
= 0.0002, Pearson’s
r
= − 0.2871). In addition, the droplet size exiting the nasal cannula interface was lower than that produced by the aerosol generator for all devices under test. Positioning the nebulizer immediately after the humidification chamber yielded a marginally greater emitted dose (3.79%) than when the nebulizer was placed immediately upstream of the nasal cannula (3.39%). Flow rate, input droplet size, and nebulizer position were at the 0.10 level of significance, indicating that all three factors had significant effects on emitted dose. According to the DOE model, flow rate had the greatest influence on emitted dose, followed by input droplet size and then nebulizer position.
Conclusion
Our findings indicate that in order to optimize the amount of aerosol exiting the nasal cannula interface during HFNT, it is necessary for gas flow rate to be low and the input droplet size to be small, while the nebulizer should be positioned immediately after the humidification chamber.
Funding
Aerogen Limited.</abstract><cop>Tarporley</cop><pub>Springer Healthcare Communications</pub><pmid>32026245</pmid><doi>10.1007/s41030-018-0054-x</doi><tpages>14</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aerosol Design of experiments Droplet size Emitted dose Family Medicine Flow rate Gas flow General Practice High-flow nasal therapy Internal Medicine Medicine & Public Health Original Research Pharmacoeconomics and Health Outcomes Pharmacotherapy Pneumology/Respiratory System Quality of Life Research |
| title | In Vitro Determination of the Main Effects in the Design of High-Flow Nasal Therapy Systems with Respect to Aerosol Performance |
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