Evidence map›Paper›PMID 38981652›Full record

ArticleRespiratory care2024

Aerosol Delivery Efficiency With High-Flow Nasal Cannula Therapy in Neonatal, Pediatric, and Adult Nasal Upper-Airway and Lung Models.

Robert M DiBlasi, Rebecca J Engberg, Jonathan Poli, Kristen E Carlin, Niko Kontoudios, P Worth Longest, Masaki Kajimoto

Abstract read
In one paragraph

Article in Respiratory care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Robert M DiBlasiRespiratory Therapy Department, Seattle Children's Hospital, Seattle, Washington; and Center for Respiratory Biology and Therapeutics, Seattle Children's Research Institute, Seattle, Washington robert.diblasi@seattlechildrens.org.
Rebecca J EngbergCenter for Respiratory Biology and Therapeutics, Seattle Children's Research Institute, Seattle, Washington; and Pediatric Intensive Care Unit, Seattle Children's Hospital, Seattle, Washington.
Jonathan PoliCenter for Respiratory Biology and Therapeutics, Seattle Children's Research Institute, Seattle, Washington.
Kristen E CarlinCenter for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington.
Niko KontoudiosRespiratory Therapy Department, Seattle Children's Hospital, Seattle, Washington; and Center for Respiratory Biology and Therapeutics, Seattle Children's Research Institute, Seattle, Washington.
P Worth LongestDepartment of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, Virginia.
Masaki KajimotoCenter for Respiratory Biology and Therapeutics, Seattle Children's Research Institute, Seattle, Washington.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigh-flow nasal cannula (HFNC) systems employ different methods to provide aerosol to patients. This study compared delivery efficiency, particle size, and regional deposition of aerosolized bronchodilators during HFNC in neonatal, pediatric, and adult upper-airway and lung models between a proximal aerosol adapter and distal aerosol circuit chamber.

methodsA filter was connected to the upper airway to a spontaneously breathing lung model. Albuterol was nebulized using the aerosol adapter and circuit at different clinical flow settings. The aerosol mass deposited in the upper airway and lung was quantified. Particle size was measured with a laser diffractometer. Regional deposition was assessed with a gamma camera at each nebulizer location and patient model with minimum flow settings.

resultsInhaled lung doses ranged from 0.2-0.8% for neonates, 0.2-2.2% for the small child, and 0.5-5.2% for the adult models. Neonatal inhaled lung doses were not different between the aerosol circuit and adapter, but the aerosol circuit showed marginally greater lung doses in the pediatric and adult patient models. Impacted aerosols and condensation in the non-heated HFNC and aerosol delivery components contributed to the dispersion of coarse liquid droplets, high deposition (11-44%), and occlusion of the supine neonatal upper airway. In contrast, the upright pediatric and adult upper-airway models had minimal deposition (0.3-7.0%) and high fugitive losses (∼24%) from liquid droplets leaking out of the nose. The high impactive losses in the aerosol adapter (56%) were better contained than in the aerosol circuit, resulting in less cannula sputter (5% vs 22%), fewer fugitive losses (18% vs 24%), and smaller inhaled aerosols (5 µm vs 13 µm).

conclusionsThe inhaled lung dose was low (1-5%) during HFNC. Approaches that streamline aerosol delivery are needed to provide safe and effective therapy to patients receiving aerosolized medications with this HFNC system.

Indexed as

AerosolsBronchodilator AgentsCannulaLungNebulizers and VaporizersParticle SizeAdministration, InhalationAdultAlbuterolChildDrug Delivery SystemsEquipment DesignHumansInfantInfant, NewbornModels, AnatomicAerosolsAlbuterolBronchodilator Agentsaerosol deliverybronchodilatorhigh-flow nasal cannulalung dosescintigraphyvibrating mesh nebulizer

Identifiers

PMID38981652
PMCPMC11349594

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.