Assessment of a Ventilator Circuit Adapter to be Used in … · 2020-04-06 · Assessment of a...
Transcript of Assessment of a Ventilator Circuit Adapter to be Used in … · 2020-04-06 · Assessment of a...
Assessment of a Ventilator Circuit Adapter to be Used in Conjunction with the Respimat† Soft Mist Inhaler
RAtIonAle•WiththeintroductionoftheRespimat†SoftMistInhaler(SMI)thereisadesireforanadaptertoallowitsuseinventilatorcircuits.Anadapter(RespiConnect*Adapter)wasassessedintermsofdrugdeliveryandsafetyfeatures.
•Patientsonmechanicalventilationeitherinvolvingprophylacticdeliveryofbronchodilators,orreceivingsuchmedicationtotreatasevereCOPDexacerbationmayneedcontinuoustherapy
Excellence By Design
J. Suggett, M. NagelTrudellMedicalInternational,London,Canada.
MD-800A-0717.*trade-marksandregisteredtrade-marksofTrudellMedicalInternational.†trade-marksandregisteredtrade-marksofBoehringerIngelheim.Copyright©TrudellMedicalInternational2017.
ERS International Congress Milan, Italy
September 9 – 13, 2017
MethodS•Eachadapter(n=10)wasinsertedintheinspiratorylimbofaheatedadultventilatorcircuit
•A7.0mmEndotrachealTube(ET)wasattachedtoafilterandthedistalsideofthefiltercoupledtoanadulttestlungtosimulateapatient
•AServoventilator(SV900C,Siemens,Sweden)deliveredtherequiredbreathingpattern:
•tidalvolume(Vt)=600mL
•10breaths/minute
•Inspiratory/expiratory(I/E)ratio=1:3
•5cmH2OPositiveEndExpiratoryPressure(PEEP)
ReSUltS•Duringtheexperimentthecircuitdidnotlosepressureandnoalarmsweretriggered,indicatingthattheselfsealingvalvewaseffective
•Meanvaluesof30.3%and29.4%LCweredeterminedforSALandIPRrespectively
ConClUSIonS•Itisknownthatnothavingagoodconsistentsealcanjeopardizethesafetyofthepatientthroughcircuitleakagesandaconsistentsealisalsoneededinordertoachieveadequatedrugdeliverytothepatient
•thepresenceofaself-sealingvalveandsafetycapfortheRespiConnect*Adaptershouldensureventilatorcircuitintegrityandthereforealsohelpprotectthesafetyofthepatient
•Approximately30%LCofbothdrugcomponentsintheSMIwasdeliveredtothedistalendofETtubeviatheadapter
•thisstudyprovidescliniciansassuranceregardingcircuitintegrityandlikelydrugdeliveryperformancewhenusingtheRespiConnect*Adapter
•Aventilatorcircuithumidifier(modelMR50JHU,Fischer-Paykel,Auckland,NZ)wasusedtomaintainconditionsclosetobodytemperatureandsaturationwithwatervapour
•FiveactuationsofCombivent†SMIweredelivered,eachactuationfollowedby6completebreathingcycles
•BetweenactuationstheSMIwasremovedfromtheadapterandprimedaccordingtomanufacturer’sinstructions
•Salbutamol(SAL)andIpratropium(IPR)wererecoveredfromthefilterandquantifiedbyHPLCas%LabelClaim(LC)
StUdY PURPoSe•theRespiConnect*Adapterwasdesignedforsafetyandmechanicalperformance
•theself-sealingmechanicalvalvemaintainstheintegrityoftheventilatorcircuitatalltimes;aredundantcapisincorporatedforextrasafety
•thisstudyassessedmechanicalperformancethroughitsabilitytoretaincircuitintegrityaswellasaerosoldrugdeliveryinaventilator
RespiConnect*AdapterTrudell Medical International London, Canada
RespiConnect*AdapterwithRespimat†SMI
Experimental Lab Set-up
Flow pattern of RespiConnect* Adapter with RespiConnect† SMI engaged
•AerosoldeliverywasoptimizedthroughCFDanalysisduringadapterdesign
Servo ventilator
Inhalation (humidified air)
Respimat† SMI
RespConnect* Adapter
Wye connector
ET Filter
Adult test lung
Circuit humidifierExhalation
Drug In
Air + Drug Out Air Out