Asthma and Quantifying Delivery Of Radio Labeled Aerosol
Condition: Asthma
MeSH terms: Asthma
Study type: Interventional

Summary: 
      Introduction: Inhalation therapy has been established as an efficient route to treat asthma
      exacerbations, but coupled to noninvasive ventilation (NIV) remains quite challenging.

      Objectives: The aim of this study were to compare radiaoaerosol pulmonary index and
      radioaerosol mass balance in the different compartments (pulmonary and extrapulmonary) using
      vibrating mesh nebulizers (VMN) and jet nebulizer (JN) coupled to noninvasive ventilation
      (NIV).

      Material and methods: The investigators assessed 10 stable moderate to severe asthmatics in a
      crossover study. Patients was randomly assigned to participate in both phases of the study:
      Phase 1(NIV+MN) and phase 2(NIV+JN). DTPA-Tc99m with radioactivity of 25 miC was used to
      inhaler using JN positioned in the circuit using a "T" piece, particle size generation in a
      five micron range and oxygen flow tritated at eight L/min and MN was positioned in the mask,
      particle size generation in a one range and connected to electrical energy. NIV was used a
      bilevel pressure through a face mask attached with straps and pressure adjusted were 12 cmH2O
      and 5 cmH2O as inspiratory and expiratory pressures, respectively. After, radioactivity
      counts were performed using a gama camera and regions of interest were delimited. To
      calculate aerosol mass balance the investigators considered the amount of radioaerosol
      deposited into the lungs, upper airways, stomach, nebulizer, circuit, inspiratory and
      expiratory filters, and mask divided for each of these compartments and represented as a
      percentage.
    


Intervention name(s): Noninvasive ventilation; Jet nebulizer; The vibrating mesh nebulizer (VMN)
Intervention type(s): Other; Device; Device
Intervention description(s): Bilevel positive pressure (BiPAP Synchrony, Respironics®, Murrysville, Pennsylvania, USA) was applied through face mask (Comfort Full 2, Respironics®, Murrysville, Pennsylvania, USA) attached with straps and pressure adjusted were 12 cmH2O of inspiratory pressure and 5 cmH2O of expiratory pressure at the beginning of the procedure (França et al., 2006).; Both nebulizers were charged with 2.5 mg of salbutamol and 0.25 mg of ipratropium bromide and 3 mL of saline solution was added to complete 3 Ml. JN (Mist yMax, Air Life, Yorba Linda, USA) was positioned in the circuit using a "T" piece, particle size generation in a 5 µm range (according to the manufacturer information) and flow oxygen tritated at 8 L/min.; Both nebulizers were charged with 2.5 mg of salbutamol and 0.25 mg of ipratropium bromide and 3 mL of saline solution was added to complete 3 Ml. VMN (Aeroneb Solo, Galway, Ireland) was positioned in the mask using an elbow (Elbow Kit, Respironics®, Murrysville, Pennsylvania, USA), particle size generation in a 1 µm and connected to electrical energy.
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: vibrating mesh nebulizers; noninvasive ventilation; residual volume; pulmonary scintigraphy; radioaerosol; nebulization.