Impact of Gas Flow and Humidity on Trans-Nasal Aerosol Deposition via Nasal Cannula in Adults: A Randomized Cross-Over Study

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dc.contributor.authorAlcoforado, Luciana
dc.contributor.authorAri, Arzu
dc.contributor.authorde Melo Barcelar, Jacqueline
dc.contributor.authorBrandao, Simone Cristina S.
dc.contributor.authorFink, James B.
dc.contributor.authorDornelas de Andrade, Armele
dc.date.accessioned2019-07-29T22:10:56Z
dc.date.available2019-07-29T22:10:56Z
dc.date.issued2019-07
dc.description.abstractBackground: Trans-nasal pulmonary aerosol delivery using high flow nasal cannula (HFNC) devices is described with the administration of high gas flows exceeding patient inspiratory flow (HF) and with lower flows (LF). The aim of this pilot clinical trial was to compare deposition and distribution of radiolabeled aerosol via nasal cannula in healthy adults across three rates of gas flow delivered with active heated humidification, and to further identify the impact of aerosol administration without heated humidity. Methods: Twenty-three (23) healthy adults (16F) were randomized to receive aerosol with active heated humidification or unheated oxygen at gas flows of 10 L/min (n = 8), 30 L/min (n = 7), or 50 L/min (n = 8). Diethylenetriaminepentaacetic acid labeled with 1 millicurie (37 MBq) of Technetium-99m (DTPA-Tc99m) was mixed with NaCl to a fill volume of 1 mL, and administered via mesh nebulizer placed at the inlet of the humidifier. Radioactivity counts were performed using a gamma camera and the regions of interest (ROIs) were delimited with counts from the lungs, upper airways, stomach, nebulizer, circuit, and expiratory filter. A mass balance was calculated and each compartment was expressed as a percentage of the total. Results: Lung deposition (mean ± SD) with heated humidified gas was greater at 10 L/min than 30 L/min or 50 L/min (17.2 ± 6.8%, 5.71 ± 2.04%, and 3.46 ± 1.24%, respectively; p = 0.0001). Using unheated carrier gas, a lung dose of aerosol was similar to the active heated humidification condition at 10 L/min, but greater at 30 and 50 L/min (p = 0.011). Administered gas flow and lung deposition were negatively correlated (r = −0.880, p < 0.001). Conclusions: Both flow and active heated humidity inversely impact aerosol delivery through HFNC. Nevertheless, aerosol administration across the range of commonly used flows can provide measurable levels of lung deposition in healthy adult subjects.
dc.description.departmentRespiratory Care
dc.formatText
dc.format.extent13 pages
dc.format.medium1 file (.pdf)
dc.identifier.citationAlcoforado, L., Ari, A., Barcelar, J. M, Brandão, S. C. S., Fink, J. B., & de Andrade, A.D. (2019). Impact of gas flow and humidity on trans-nasal aerosol deposition via nasal cannula in adults: A randomized cross-over study. Pharmaceutics, 11(7): 320.
dc.identifier.doihttps://doi.org/10.3390/pharmaceutics11070320
dc.identifier.issn1999-4923
dc.identifier.urihttps://hdl.handle.net/10877/8412
dc.language.isoen
dc.publisherMultidisciplinary Digital Publishing Institute
dc.rights.licenseThis work is licensed under a Creative Commons Attribution 4.0 International License.
dc.sourcePharmaceutics, 2019, Vol. 11, No. 7, Article 320.
dc.subjecthumidity
dc.subjectaerosol
dc.subjectscintigraphy
dc.subjectoxygen
dc.subjectnebulizer
dc.subjectnasal cannula
dc.subjectRespiratory Care
dc.titleImpact of Gas Flow and Humidity on Trans-Nasal Aerosol Deposition via Nasal Cannula in Adults: A Randomized Cross-Over Study
dc.typeArticle

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