PMID- 32026245
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240406
IS  - 2364-1746 (Electronic)
IS  - 2364-1754 (Print)
IS  - 2364-1754 (Linking)
VI  - 4
IP  - 1
DP  - 2018 Jun
TI  - In Vitro Determination of the Main Effects in the Design of High-Flow Nasal 
      Therapy Systems with Respect to Aerosol Performance.
PG  - 73-86
LID - 10.1007/s41030-018-0054-x [doi]
AB  - 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 microm, 2.76% with 4.05 microm, 
      and 2.38% with 4.88 microm, 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.
FAU - Bennett, Gavin
AU  - Bennett G
AD  - Aerogen Limited, IDA Business Park, Dangan, Galway, Ireland. 
      GBennett@aerogen.com.
FAU - Joyce, Mary
AU  - Joyce M
AD  - Aerogen Limited, IDA Business Park, Dangan, Galway, Ireland.
FAU - Sweeney, Louise
AU  - Sweeney L
AD  - Aerogen Limited, IDA Business Park, Dangan, Galway, Ireland.
FAU - MacLoughlin, Ronan
AU  - MacLoughlin R
AD  - Aerogen Limited, IDA Business Park, Dangan, Galway, Ireland.
LA  - eng
PT  - Journal Article
DEP - 20180418
PL  - United States
TA  - Pulm Ther
JT  - Pulmonary therapy
JID - 101687144
PMC - PMC6967237
OTO - NOTNLM
OT  - Aerosol
OT  - Design of experiments
OT  - Droplet size
OT  - Emitted dose
OT  - Flow rate
OT  - High-flow nasal therapy
OT  - Nebulizer
COIS- Gavin Bennett is an employee of Aerogen Limited. Mary Joyce is an employee of 
      Aerogen Limited. Louise Sweeney is an employee of Aerogen Limited. Ronan 
      MacLoughlin is an employee of Aerogen Limited.
EDAT- 2018/06/01 00:00
MHDA- 2018/06/01 00:01
PMCR- 2018/06/01
CRDT- 2020/02/07 06:00
PHST- 2018/03/01 00:00 [received]
PHST- 2020/02/07 06:00 [entrez]
PHST- 2018/06/01 00:00 [pubmed]
PHST- 2018/06/01 00:01 [medline]
PHST- 2018/06/01 00:00 [pmc-release]
AID - 10.1007/s41030-018-0054-x [pii]
AID - 54 [pii]
AID - 10.1007/s41030-018-0054-x [doi]
PST - ppublish
SO  - Pulm Ther. 2018 Jun;4(1):73-86. doi: 10.1007/s41030-018-0054-x. Epub 2018 Apr 18.