Evaluation of aerosol drug delivery with concurrent low- and high-flow nasal oxygen

Abstract

Question addressed by study Administration of aerosol to patients receiving high-flow nasal oxygen (HFNO) ranges from concurrent aerosol delivery by mouthpiece to aerosol via cannula alone. This study examines the conditions to provide optimal aerosol delivery with low- or high-flow nasal oxygen with concurrent mouthpiece or through nasal cannula alone, and the impact on fugitive aerosols. Materials and methods A vibrating mesh nebuliser delivered salbutamol via mouthpiece, aerosol holding chamber and nasal cannula to an adult head model simulating relaxed breathing. The mean±sd inhaled dose (%) was assayed from a filter distal to the trachea. Optical particle sizers were used to measure fugitive aerosol concentrations during aerosol delivery. Results Concurrent low-flow nasal oxygen (LFNO) and aerosol delivery with a mouthpiece and aerosol holding chamber increased the inhaled dose (%) available, 31.44±1.33% when supplemented with 2 L·min−1 of nasal oxygen. Concurrent HFNO above 30 L·min−1 resulted in a lower inhaled dose (%) compared to aerosol delivered through HFNO alone. The addition of concurrent LFNO or HFNO resulted in no increase in aerosol levels in the test room. Answer to question posed Concurrent LFNO with a mouthpiece and aerosol holding chamber is an effective and safe means of aerosol delivery.