- Oral presentation
- Open Access
Lung Deposition of a Radiolabeled Aerosol With Two Ventilation Modalities During Invasive Mechanical Ventilation: A Randomized Comparative Study
© Dugernier et al.; 2015
- Published: 1 October 2015
- Endotracheal Tube
- Pressure Support
- Pressure Support Ventilation
- Inspiratory Flow
- Spontaneous Ventilation
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.
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).
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.
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.
Volume-controlled ventilation improved lung deposition of aerosolized particles as compared to pressure support ventilation. The clinical benefit of this effect warrants further studies.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.