In vitro comparison of unit dose vs infusion pump administration of albuterol via high-flow nasal cannula in toddlers.
Pediatr Pulmonol
; 55(2): 322-329, 2020 02.
Article
in English
| MEDLINE | ID: covidwho-1064412
ABSTRACT
OBJECTIVES:
Transnasal pulmonary aerosol delivery using high-flow nasal cannula (HFNC) devices has become a popular route of aerosol administration in toddlers. Clinically, albuterol is administered using an infusion pump or unit doses. However, little evidence is available to compare the two administration strategies.METHODS:
A toddler manikin (15 kg) with appropriate anatomic airway was connected with collecting filter to a simulator of distressed breathing. HFNC device with mesh nebulizer placed at the inlet of a humidifier at 37°C, with the gas flow set at 25 and 3.75 L/min. Five milligrams of albuterol was delivered in all experiments. With infusion pump administration, albuterol concentrations of 5 and 1 mg/mL were delivered at 4 and 20 mL/hr for 15 minutes. With unit dose administration, 1 mL (5 mg/mL) and 2 mL (2.5 mg/mL) of albuterol were nebulized. Additional tests with mouth open and nebulizers via mask were using 5 mg/1 mL for mesh nebulizer and 5 mg/3 mL for jet nebulizer (n = 3). The drug was eluted from the filter and assayed with UV spectrophotometry (276 nm).RESULTS:
The inhaled dose was higher with unit dose than infusion pump administration with gas flows of 25 L/min (2.66 ± 0.38 vs 1.16 ± 0.28%; P = .004) and 3.75 L/min (10.51 ± 1.29 vs 8.58 ± 0.68%; P = .025). During unit dose administration, compared with closed-mouth breathing, open-mouth breathing generated a higher inhaled dose at 3.75 L/min and lower inhaled dose at 25 L/min. Compared to the nebulizers via mask with both open and closed-mouth breathing, nebulization via HFNC at 3.75 L/min generated greater inhaled dose, while HFNC at 25 L/min generated lower inhaled dose.CONCLUSIONS:
During transnasal aerosol delivery, the inhaled dose was higher with medication administrated using unit dose than using an infusion pump.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Bronchodilator Agents
/
Albuterol
/
Cannula
Type of study:
Prognostic study
Limits:
Child, preschool
/
Humans
Language:
English
Journal:
Pediatr Pulmonol
Journal subject:
Pediatrics
Year:
2020
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS