P38 Does spacer/adapter device choice affect delivery of a pressurized metered dose inhaler (pMDI) through a humidified circuit to a simulated patient on mechanical ventilation
Bibliographic record
Abstract
Introduction Delivery of aerosolized medication to mechanically ventilated patients is a key element of their treatment. To reduce the risk of infection or derecruitment it is desirable to not break the ventilation circuit. This study evaluates the effect pMDI delivery devices have on drug delivery in an adult ventilator setting. Methods An adult mechanical ventilation circuit (Fischer&Paykel RT210) was humidified (T=37â°C, 100%RH), and a simulated ventilated adult model (500 mL, duty cycle = 33%, 13 breaths/minute) was generated using a Draeger Infinity† C500 ventilator. An aerosol collection filter was located at the distal end of the 8.0mm diameter endotracheal tube (ETT) and the far-side of the filter was coupled to a Draeger SelfTestLung† simulating the patient. 5-actuations of a Ventolin† pMDI were delivered through the device on test, each time followed by 6-complete breathing cycles, shaking the canister between actuations. This procedure (n=5/device) was performed with AeroChamber* VENT Holding Chamber (HC), Spirale† DDS, or Hudson RCI† MDI Adaptor placed in the inspiratory limb, or via the built-in pMDI port adapter within the wye connector of the circuit. Assay of recovered salbutamol was undertaken by HPLC-UV spectrophotometry. Results Conclusions We have shown device type influences aerosolized drug delivery during adult mechanical ventilation. Although Spirale† DDS closely resembles AeroChamber* VENT HC (also marketed as AeroVent Plus* Collapsible Holding Chamber), the Spirale† bellows had difficulties keeping a spacer-like shape when expanded for aerosol delivery. This study highlights the variability in drug delivery using a pMDI and that spacer/adapter choice are critical factors to be considered when using these devices as a treatment option.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".