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Lung Deposition of a Radiolabeled Aerosol With Two Ventilation Modalities During Invasive Mechanical Ventilation: A Randomized Comparative Study

Intensive Care Medicine Experimental volume 3, Article number: A10 (2015) Cite this article

Introduction

Volume-controlled ventilation has been suggested during nebulization to optimize lung deposition although promoting spontaneous ventilation is targeted for ventilated patient management. Comparing topographic lung aerosol deposition during volume-controlled and spontaneous ventilation in pressure support has never been performed.

Objectives

The aim of this study was to compare lung deposition of a radiolabeled aerosol generated with a vibrating-mesh nebulizer during invasive mechanical ventilation, using two ventilation modes: pressure support ventilation (PS) and volume-controlled ventilation (VC).

Methods

Seventeen postoperative neurosurgical patients without pulmonary disease volunteered to participate in the study and were randomly ventilated in PS (n = 8) or VC (n = 9) with constant inspiratory flow. Diethylenetriaminepentaacetic acid labelled with technetium-99 m (2 mCi/3 mL) was administered using a vibrating-mesh nebulizer (Aerogen Solo®, Aerogen Ltd., Galway, Ireland) connected to the endotracheal tube. Pulmonary and extrapulmonary particles deposition was analyzed by planar scintigraphy.

Results

Mean lung deposition expressed as a percent of nominal dose was 10.5 ± 3.0% and 15.1 ± 5.0% during PS and VC, respectively (p < 0.05). Higher endotracheal tube and tracheal deposition was observed during PS (27.4 ± 6.6% versus 20.7 ± 6.0%, p < 0.05). a similar aerosol penetration from the inner to the outer region of the right lung (p = 0.347) and the left lung (p = 0.239) was observed.

Conclusions

Volume-controlled ventilation improved lung deposition of aerosolized particles as compared to pressure support ventilation. The clinical benefit of this effect warrants further studies.

Author information

Authors and Affiliations

  1. Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Intensive Care Unit, Brussels, Belgium

    J Dugernier, X Wittebole, J Roeseler, P Hantson & PF Laterre

  2. Université Catholique de Louvain, Institut de Recherche Expérimentale et Clinique (IREC), Pneumology, Brussels, Belgium

    G Reychler

  3. Clinique Notre-Dame de Grâce, Intensive Care Unit, Gosselies, Belgium

    T Sottiaux

  4. Haute Ecole de Santé Vaud, Lausanne, Switzerland

    JB Michotte

  5. Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Louvain Drug Research Institute, Brussels, Belgium

    R Vanbever

  6. Clinique Saint-Pierre, Intensive Care Unit, Ottignies, Belgium

    T Dugernier

  7. Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Department of Interventional Radiology, Brussels, Belgium

    P Goffette

  8. Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Department of Anesthesiology, Brussels, Belgium

    MA Docquier

  9. Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Department of Neurosurgery, Brussels, Belgium

    C Raftopoulos

  10. Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Department of Nuclear Medicine, Brussels, Belgium

    F Jamar

Authors
  1. J Dugernier
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  2. G Reychler
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  3. X Wittebole
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  4. J Roeseler
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  5. T Sottiaux
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  6. JB Michotte
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  7. R Vanbever
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  8. T Dugernier
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  9. P Goffette
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  10. MA Docquier
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  11. C Raftopoulos
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  12. P Hantson
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  13. F Jamar
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  14. PF Laterre
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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Cite this article

Dugernier, J., Reychler, G., Wittebole, X. et al. Lung Deposition of a Radiolabeled Aerosol With Two Ventilation Modalities During Invasive Mechanical Ventilation: A Randomized Comparative Study. ICMx 3 (Suppl 1), A10 (2015). https://doi.org/10.1186/2197-425X-3-S1-A10

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  • DOI: https://doi.org/10.1186/2197-425X-3-S1-A10

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