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Nebuliser type influences both patient-derived bioaerosol emissions and ventilation parameters during mechanical ventilation

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journal contribution
posted on 15.03.2022, 14:56 authored by Mary Joyce, James A McGrath, Marc Mac Giolla Eain, Andrew O'Sullivan, Miriam Byrne, Ronan MacLoughlinRonan MacLoughlin
COVID-19 may lead to serious respiratory complications which may necessitate ventilatory support. There is concern surrounding potential release of patient-derived bioaerosol during nebuliser drug refill, which could impact the health of caregivers. Consequently, mesh nebulisers have been recommended by various clinical practice guidelines. Currently, there is a lack of empirical data describing the potential for release of patient-derived bioaerosol during drug refill. This study examined the release of simulated patient-derived bioaerosol, and the effect on positive end expiratory pressure during nebuliser refill during mechanical ventilation of a simulated patient. During jet nebuliser refill, the positive end expiratory pressure decreased from 4.5 to 0 cm H2O. No loss in pressure was noted during vibrating mesh nebuliser refill. A median particle number concentration of 710 particles cm-3 above ambient was detected when refilling the jet nebuliser in comparison to no increase above ambient detected when using the vibrating mesh nebuliser. The jet nebuliser with the endotracheal tube clamped resulted in 60 particles cm-3 above ambient levels. This study confirms that choice of nebuliser impacts both the potential for patient-derived bioaerosol release and the ability to maintain ventilator circuit pressures and validates the recommended use of mesh nebulisers during mechanical ventilation.

Funding

Aerogen Limited

History

Comments

The original article is available at https://www.mdpi.com/

Published Citation

Joyce M, McGrath JA, Mac Giolla Eain M, O'Sullivan A, Byrne M, MacLoughlin R. Nebuliser type influences both patient-derived bioaerosol emissions and ventilation parameters during mechanical ventilation. Pharmaceutics. 2021;13(2):199

Publication Date

2 February 2021

PubMed ID

33540764

Department/Unit

  • School of Pharmacy and Biomolecular Sciences

Publisher

MDPI

Version

  • Published Version (Version of Record)