Evaluation of aerosol delivery in a simulated spontaneously breathing tracheostomy mask patient

Introduction: Aerosolised medication is commonly delivered by means of a nebuliser attached to a tracheostomy mask in the treatment of respiratory illnesses in tracheostomy patients. The objective of this study was to assess the aerosol delivery performance of a vibrating mesh nebuliser (VMN) attached to a tracheostomy mask with a T-piece or an aerosol chamber using a simulated spontaneous breathing model. Methods: An adult head model with an intubated tracheostomy tube (Shiley, Medtronic, Ireland) was attached, via a capturing filter (Respirgard, Baxter, Ireland) to a breathing simulator (IngMar Medical, US) set to simulate normal adult breathing (Vt 500mL, 15BPM, I:E ratio 1:1). The VMN (Aerogen, Ireland) was attached to a tracheostomy mask (Hudson RCI 1075, Teleflex, US), via a T-piece (Aerogen, Ireland) or an aerosol chamber (Aerogen, Ireland) and placed on the neck of the head model. Supplemental gas flows of 0, 2 & 6 LPM were used with the aerosol chamber. A 2mL dose of 2mg/mL Salbutamol was aerosolised. The mass of drug was analysed using UV spectrophotometry at 276 nm. Results: Table 1. Mean ± standard deviation values of inhaled dose. Conclusions: Aerosol delivery can be achieved using a VMN attached to a tracheostomy mask with a T-piece or an aerosol chamber. Increasing supplemental gas flows were associated with an increase in inhaled dose