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Jason Oakley - One of the best experts on this subject based on the ideXlab platform.

  • droplet size and distribution of nebulized 3 nacl albuterol and epoprostenol by phase doppler particle analyzer
    Current Therapeutic Research-clinical and Experimental, 2021
    Co-Authors: Kelly Mcdermott, Jason Oakley
    Abstract:

    Abstract Purpose : Aerosolized drug therapy administered to mechanically ventilated patients is a standard part of pulmonary critical care medicine. Aerosol particle size and distribution are important factors in the optimal delivery of aerosolized drugs to ventilated patients. The objective of this study was to characterize aerosol droplet size and distribution with laser diffraction for nebulized 3% sodium chloride (NaCl), albuterol, and epoprostenol sodium (containing glycine) delivered via Aerogen Aeroneb Solo Mesh Nebulizers. Methods : A series of functional flow tests were run on each of 8 Solo mesh nebulizers prior to the study to verify accuracy of flow rates in mL/minute. Aerosolized droplets exiting the nebulizer heads were then measured using a phase Doppler particle analyzer. Data collected during delivery of 3% NaCl, albuterol, and epoprostenol sodium included aerosol droplet size distribution, mass median aerodynamic diameter (MMAD), and geometric standard deviation. For each Solo nebulizer, droplet size measurements were taken 2 cm away from the nebulizer head and 2 cm away from the wye of a heated, humidified adult ventilator Circuit. For measurements taken at the wye, 4 distinct, continuous flow rates (2, 10, 20, and 40 L/min) were generated by an air pump to simulate inspiratory flows delivered with mechanical ventilation. The expiratory limb was capped, and the nebulizer head was inserted into the Breathing Circuit upstream of the humidifier. Findings : Each Solo nebulizer met Aerogen's recommended minimum flow rate of 0.2 mL/min, ranging from 0.23 to 0.31 mL/min. The MMAD of the 3 tested aerosols was several times smaller when measured at the wye outlet of the heated/humidified Breathing Circuit (0.82–2.73 μm) compared with droplets measured directly at the nebulizer outlet (MMAD, 4.6–7.3 µm). There was also significant variability across Solo heads with some ventilator flow rates. The mean MMAD at the wye for the 3% NaCl solution, albuterol, and epoprostenol test solutions was 1.62 µm, 1.09 µm, and 1.18 µm, respectively. The mean MMAD at the nebulizer for the 3% NaCl solution, albuterol, and epoprostenol test solutions was 5.37 µm, 5.73 µm, and 6.73 µm, respectively. Implications : Results from this study suggest that particle size of aerosolized drugs administered via a commonly used setup for delivery of in-line aerosols to mechanically ventilated patients may be several times smaller than expected and may result in less drug being delivered to the patient than previously realized.

  • droplet size and distribution of nebulized 3 sodium chloride albuterol and epoprostenol by phase doppler particle analyzer
    Current Therapeutic Research-clinical and Experimental, 2021
    Co-Authors: Kelly Mcdermott, Jason Oakley
    Abstract:

    ABSTRACT Background Aerosolized drug therapy administered to mechanically ventilated patients is a standard part of pulmonary critical care medicine. Aerosol particle size and distribution are important factors in the optimal delivery of aerosolized drugs to ventilated patients. Objective The objective of this study was to characterize aerosol droplet size and distribution with laser diffraction for nebulized 3% sodium chloride, albuterol, and epoprostenol sodium (containing glycine) delivered via Aeroneb Solo Mesh Nebulizers (Aerogen, Mountain View, California). Methods A series of functional flow tests were run on each of 8 Solo mesh nebulizers before the study to verify accuracy of flow rates in milliliters per minute. Aerosolized droplets exiting the nebulizer heads were then measured using a phase Doppler particle analyzer. Data collected during delivery of 3% sodium chloride, albuterol, and epoprostenol sodium included aerosol droplet size distribution, mass median aerodynamic diameter (MMAD), and geometric standard deviation. For each Solo nebulizer, droplet size measurements were taken 2 cm away from the nebulizer head and 2 cm away from the wye of a heated, humidified adult ventilator Circuit. For measurements taken at the wye, 4 distinct, continuous flow rates (2, 10, 20, and 40 L/min) were generated by an air pump to simulate inspiratory flows delivered with mechanical ventilation. The expiratory limb was capped, and the nebulizer head was inserted into the Breathing Circuit upstream of the humidifier. Results Each Solo nebulizer met Aerogen's recommended minimum flow rate of 0.2 mL/min, ranging from 0.23 to 0.31 mL/min. The MMAD of the 3 tested aerosols was several times smaller when measured at the wye outlet of the heated/humidified Breathing Circuit (0.82–2.73 µm) compared with droplets measured directly at the nebulizer outlet (MMAD, 4.6–7.3 µm). There was also significant variability across Solo heads with some ventilator flow rates. The mean MMAD at the wye for the 3% sodium chloride solution, albuterol, and epoprostenol test solutions was 1.62 µm, 1.09 µm, and 1.18 µm, respectively. The mean MMAD at the nebulizer for the 3% sodium chloride solution, albuterol, and epoprostenol test solutions was 5.37 µm, 5.73 µm, and 6.73 µm, respectively. Conclusions Results from this study suggest that particle size of aerosolized drugs administered via a commonly used setup for delivery of in-line aerosols to mechanically ventilated patients may be several times smaller than expected and may result in less drug being delivered to the patient than previously realized. (Curr Ther Res Clin Exp. 2021; 82:XXX–XXX) © 2021 Elsevier HS Journals, Inc.

  • droplet size and distribution of nebulized 3 nacl albuterol and epoprostenol by phase doppler particle analyzer
    Respiratory Care, 2019
    Co-Authors: Kelly Mcdermott, Jason Oakley
    Abstract:

    Background: The objective of this study was to characterize aerosol droplet size and distribution with laser diffraction for nebulized 3% NaCl, albuterol, and epoprostenol sodium. Methods: A series of flow tests were run on each of 8 Aerogen Solo nebulizer heads prior to the study to verify accuracy of flows in mL/minute. Aerosolized droplets exiting the nebulizer heads were then measured using a phase Doppler particle analyzer. Data collected during delivery of 3% NaCl, albuterol, and epoprostenol sodium included aerosol droplet size distribution, mass median aerodynamic diameter (MMAD), and geometric standard deviation. For each nebulizer head, droplet size measurements were taken at the following locations: 2 cm away from the nebulizer head and 2 cm away from the Y-piece of a heated, humidified adult ventilator Circuit. For measurements taken at the Y-piece, 4 distinct, continuous flows (2, 10, 20, and 40 L/min) were generated by an air pump to simulate inspiratory flows delivered with mechanical ventilation. The expiratory limb was capped, and the nebulizer head was inserted into the Breathing Circuit upstream of the humidifier. Results: Each Solo nebulizer met Aerogen’s recommended minimum flow of 0.2 mL/min, ranging from 0.23 to 0.31 mL/min. The MMAD of the 3 tested aerosols was several times larger when measured directly at the cup outlet (MMAD, 4.6-7.3 µm) than at the outlet of the heated/humidified Breathing Circuit (MMAD, 0.85-2.73 µm). See Figure displaying MMAD and geometric standard deviations. The lower limit of detection for droplet size of the phase Doppler particle analyzer is 0.5 µm. Conclusions: Aerosol size was smaller than expected with the simulation. Previous studies using cascade impactors to evaluate MMAD indicate that vibrating mesh nebulizers should be expected to generate droplets

Sitanggang, Ruli Herman - One of the best experts on this subject based on the ideXlab platform.

  • Gambaran Kontaminasi Bakteri pada Sirkuit Pernapasan Anestesi di Ruang Operasi Rumah Sakit Dr. Hasan Sadikin Bandung pada Bulan Agustus 2015
    'Jurnal Anestesi Perioperatif (JAP)', 2017
    Co-Authors: Suryadi Suryadi, Fuadi Iwan, Sitanggang, Ruli Herman
    Abstract:

    Rumah Sakit Dr. Hasan Sadikin Bandung memakai sirkuit pernapasan dalam melakukan tindakan anestesi di ruang operasi. Sirkuit tersebut digunakan berulang dan diganti setiap 24 jam. Penelitian ini dilakukan untuk mengetahui gambaran kontaminasi bakteri pada sirkuit pernapasan anestesi. Penelitian dilakukan dengan metode deskriptif observasional secara cross–sectional. Sebanyak 102 sampel dari 51 sirkuit pernapasan anestesi diperiksa kultur bakteri sebelum dan sesudah digunakan pada ruang operasi Rumah Sakit Dr. Hasan Sadikin Bandung selama 3 hari pada bulan Agustus 2015. Pengambilan sampel dilakukan dengan metode apus pada konektor Y sirkuit pernapasan anestesi sebelum dan sesudah digunakan dalam 24 jam. Hasil penelitian ini menunjukkan tidak ada kontaminasi bakteri pada sirkuit pernapasan anestesi sebelum digunakan pada ruang operasi Rumah Sakit Dr. Hasan Sadikin Bandung. Kontaminasi bakteri pada sirkuit pernapasan anestesi sesudah digunakan pada ruang operasi Rumah Sakit Dr. Hasan Sadikin Bandung adalah 25,49%. Gambaran pola bakteri yang teridentifikasi adalah bakteri Micrococcus spp., Bacillus spp., Streptococcus viridans, Serratia marcescens, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus hominis, dan Staphylococcus saprophyticus. Simpulan penelitian ini adalah tidak ditemukan kontaminasi bakteri pada sirkuit pernapasan anestesi sebelum digunakan dan ditemukan kontaminasi bakteri pada sirkuit pernapasan anestesi sesudah digunakan pada ruang operasi Rumah Sakit Dr. Hasan Sadikin Bandung.Kata kunci: Gambaran pola bakteri, kontaminasi bakteri, sirkuit pernapasan anestesi Description of Bacteria Contamination in Anesthesia Breathing Circuit in Operating Room Dr. Hasan Sadikin Bandung General Hospital in August 2015Breathing Circuits have been used repeatedly to perform anesthesia in the operating theater of Dr. Hasan Sadikin General Hospital with a replacement interval of every 24 hours. This study was conducted to determine the contamination of bacteria in the anesthesia Breathing Circuits. This was an observational descriptive cross–sectional study on 102 samples from 51 anesthesia Breathing Circuits. These samples were cultured before and after the use of Breathing Circuit in the operating room of Dr. Hasan Sadikin General Hospital for 3 days in August 2015. Sampling was performed using swab method at the Y connector of anesthesia Breathing Circuit before and after use within a period of 24 hours. The results showed that no bacterial contamination was found in the anesthesia Breathing Circuit before use in the operating theatre of Dr. Hasan Sadikin Hospital Bandung. Bacterial contamination of anesthesia Breathing Circuit after use was 25.49%. The bacteria identified were Micrococcus spp., Bacillus spp., Streptococcus viridans, Serratia marcescens, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus hominis and Staphylococcus saprophyticus. It is concluded that no bacterial contamination of anesthesia Breathing Circuit before use; however, bacterial contamination was found after the use of anesthesia Breathing Circuits in the operating theatre of Dr. Hasan Sadikin General Hospital Bandung.Key words: Anesthesia Breathing Circuits, bacterial contamination, description of the bacteria

Kelly Mcdermott - One of the best experts on this subject based on the ideXlab platform.

  • droplet size and distribution of nebulized 3 nacl albuterol and epoprostenol by phase doppler particle analyzer
    Current Therapeutic Research-clinical and Experimental, 2021
    Co-Authors: Kelly Mcdermott, Jason Oakley
    Abstract:

    Abstract Purpose : Aerosolized drug therapy administered to mechanically ventilated patients is a standard part of pulmonary critical care medicine. Aerosol particle size and distribution are important factors in the optimal delivery of aerosolized drugs to ventilated patients. The objective of this study was to characterize aerosol droplet size and distribution with laser diffraction for nebulized 3% sodium chloride (NaCl), albuterol, and epoprostenol sodium (containing glycine) delivered via Aerogen Aeroneb Solo Mesh Nebulizers. Methods : A series of functional flow tests were run on each of 8 Solo mesh nebulizers prior to the study to verify accuracy of flow rates in mL/minute. Aerosolized droplets exiting the nebulizer heads were then measured using a phase Doppler particle analyzer. Data collected during delivery of 3% NaCl, albuterol, and epoprostenol sodium included aerosol droplet size distribution, mass median aerodynamic diameter (MMAD), and geometric standard deviation. For each Solo nebulizer, droplet size measurements were taken 2 cm away from the nebulizer head and 2 cm away from the wye of a heated, humidified adult ventilator Circuit. For measurements taken at the wye, 4 distinct, continuous flow rates (2, 10, 20, and 40 L/min) were generated by an air pump to simulate inspiratory flows delivered with mechanical ventilation. The expiratory limb was capped, and the nebulizer head was inserted into the Breathing Circuit upstream of the humidifier. Findings : Each Solo nebulizer met Aerogen's recommended minimum flow rate of 0.2 mL/min, ranging from 0.23 to 0.31 mL/min. The MMAD of the 3 tested aerosols was several times smaller when measured at the wye outlet of the heated/humidified Breathing Circuit (0.82–2.73 μm) compared with droplets measured directly at the nebulizer outlet (MMAD, 4.6–7.3 µm). There was also significant variability across Solo heads with some ventilator flow rates. The mean MMAD at the wye for the 3% NaCl solution, albuterol, and epoprostenol test solutions was 1.62 µm, 1.09 µm, and 1.18 µm, respectively. The mean MMAD at the nebulizer for the 3% NaCl solution, albuterol, and epoprostenol test solutions was 5.37 µm, 5.73 µm, and 6.73 µm, respectively. Implications : Results from this study suggest that particle size of aerosolized drugs administered via a commonly used setup for delivery of in-line aerosols to mechanically ventilated patients may be several times smaller than expected and may result in less drug being delivered to the patient than previously realized.

  • droplet size and distribution of nebulized 3 sodium chloride albuterol and epoprostenol by phase doppler particle analyzer
    Current Therapeutic Research-clinical and Experimental, 2021
    Co-Authors: Kelly Mcdermott, Jason Oakley
    Abstract:

    ABSTRACT Background Aerosolized drug therapy administered to mechanically ventilated patients is a standard part of pulmonary critical care medicine. Aerosol particle size and distribution are important factors in the optimal delivery of aerosolized drugs to ventilated patients. Objective The objective of this study was to characterize aerosol droplet size and distribution with laser diffraction for nebulized 3% sodium chloride, albuterol, and epoprostenol sodium (containing glycine) delivered via Aeroneb Solo Mesh Nebulizers (Aerogen, Mountain View, California). Methods A series of functional flow tests were run on each of 8 Solo mesh nebulizers before the study to verify accuracy of flow rates in milliliters per minute. Aerosolized droplets exiting the nebulizer heads were then measured using a phase Doppler particle analyzer. Data collected during delivery of 3% sodium chloride, albuterol, and epoprostenol sodium included aerosol droplet size distribution, mass median aerodynamic diameter (MMAD), and geometric standard deviation. For each Solo nebulizer, droplet size measurements were taken 2 cm away from the nebulizer head and 2 cm away from the wye of a heated, humidified adult ventilator Circuit. For measurements taken at the wye, 4 distinct, continuous flow rates (2, 10, 20, and 40 L/min) were generated by an air pump to simulate inspiratory flows delivered with mechanical ventilation. The expiratory limb was capped, and the nebulizer head was inserted into the Breathing Circuit upstream of the humidifier. Results Each Solo nebulizer met Aerogen's recommended minimum flow rate of 0.2 mL/min, ranging from 0.23 to 0.31 mL/min. The MMAD of the 3 tested aerosols was several times smaller when measured at the wye outlet of the heated/humidified Breathing Circuit (0.82–2.73 µm) compared with droplets measured directly at the nebulizer outlet (MMAD, 4.6–7.3 µm). There was also significant variability across Solo heads with some ventilator flow rates. The mean MMAD at the wye for the 3% sodium chloride solution, albuterol, and epoprostenol test solutions was 1.62 µm, 1.09 µm, and 1.18 µm, respectively. The mean MMAD at the nebulizer for the 3% sodium chloride solution, albuterol, and epoprostenol test solutions was 5.37 µm, 5.73 µm, and 6.73 µm, respectively. Conclusions Results from this study suggest that particle size of aerosolized drugs administered via a commonly used setup for delivery of in-line aerosols to mechanically ventilated patients may be several times smaller than expected and may result in less drug being delivered to the patient than previously realized. (Curr Ther Res Clin Exp. 2021; 82:XXX–XXX) © 2021 Elsevier HS Journals, Inc.

  • droplet size and distribution of nebulized 3 nacl albuterol and epoprostenol by phase doppler particle analyzer
    Respiratory Care, 2019
    Co-Authors: Kelly Mcdermott, Jason Oakley
    Abstract:

    Background: The objective of this study was to characterize aerosol droplet size and distribution with laser diffraction for nebulized 3% NaCl, albuterol, and epoprostenol sodium. Methods: A series of flow tests were run on each of 8 Aerogen Solo nebulizer heads prior to the study to verify accuracy of flows in mL/minute. Aerosolized droplets exiting the nebulizer heads were then measured using a phase Doppler particle analyzer. Data collected during delivery of 3% NaCl, albuterol, and epoprostenol sodium included aerosol droplet size distribution, mass median aerodynamic diameter (MMAD), and geometric standard deviation. For each nebulizer head, droplet size measurements were taken at the following locations: 2 cm away from the nebulizer head and 2 cm away from the Y-piece of a heated, humidified adult ventilator Circuit. For measurements taken at the Y-piece, 4 distinct, continuous flows (2, 10, 20, and 40 L/min) were generated by an air pump to simulate inspiratory flows delivered with mechanical ventilation. The expiratory limb was capped, and the nebulizer head was inserted into the Breathing Circuit upstream of the humidifier. Results: Each Solo nebulizer met Aerogen’s recommended minimum flow of 0.2 mL/min, ranging from 0.23 to 0.31 mL/min. The MMAD of the 3 tested aerosols was several times larger when measured directly at the cup outlet (MMAD, 4.6-7.3 µm) than at the outlet of the heated/humidified Breathing Circuit (MMAD, 0.85-2.73 µm). See Figure displaying MMAD and geometric standard deviations. The lower limit of detection for droplet size of the phase Doppler particle analyzer is 0.5 µm. Conclusions: Aerosol size was smaller than expected with the simulation. Previous studies using cascade impactors to evaluate MMAD indicate that vibrating mesh nebulizers should be expected to generate droplets

Jonathan E Wingo - One of the best experts on this subject based on the ideXlab platform.

  • the effects of reduced end tidal carbon dioxide tension on cerebral blood flow during heat stress
    The Journal of Physiology, 2009
    Co-Authors: Jonathan E Wingo, Kimberly A Hubing
    Abstract:

    Passive heat stress reduces arterial carbon dioxide partial pressure () as reflected by 3 to 5 Torr reductions in end-tidal carbon dioxide tension (). Heat stress also reduces cerebrovascular conductance (CBVC) by up to 30%. While is a strong regulator of CBVC, it is unlikely that the relatively small change in during heating is solely responsible for the reductions in CBVC. This study tested the hypothesis that , referenced by , is not the sole mechanism for reductions in CBVC during heat stress. Mean arterial blood pressure (MAP), , middle cerebral artery blood velocity (MCA Vmean), and calculated CBVC (MCA Vmean/MAP) were assessed in seven healthy individuals, during three separate conditions performed sequentially: (1) normothemia, (2) control passive heat stress and (3) passive heat stress with clamped at the normothermic level (using a computer-controlled sequential gas delivery Breathing Circuit). MAP was similar in the three thermal conditions (P= 0.55). Control heat stress increased internal temperature ∼1.3°C, which resulted in decreases in , MCA Vmean and calculated CBVC (P < 0.001 for all variables). During heat stress + clamp conditions internal temperature remained similar to that during the control heat stress condition (P= 0.31). Heat stress + clamp successfully restored to the normothermic level (P= 0.99) and increased MCA Vmean (P= 0.002) and CBVC (P= 0.008) relative to control heat stress. Despite restoration of , MCA Vmean (P= 0.005) and CBVC (P= 0.03) remained reduced relative to normothermia. These results indicate that heat stress-induced reductions in , as referenced by , contribute to the decrease in MCA Vmean and CBVC; however, other factors (e.g. perhaps elevated sympathetic nerve activity) are also involved in mediating this response.

Suryadi Suryadi - One of the best experts on this subject based on the ideXlab platform.

  • Gambaran Kontaminasi Bakteri pada Sirkuit Pernapasan Anestesi di Ruang Operasi Rumah Sakit Dr. Hasan Sadikin Bandung pada Bulan Agustus 2015
    'Jurnal Anestesi Perioperatif (JAP)', 2017
    Co-Authors: Suryadi Suryadi, Fuadi Iwan, Sitanggang, Ruli Herman
    Abstract:

    Rumah Sakit Dr. Hasan Sadikin Bandung memakai sirkuit pernapasan dalam melakukan tindakan anestesi di ruang operasi. Sirkuit tersebut digunakan berulang dan diganti setiap 24 jam. Penelitian ini dilakukan untuk mengetahui gambaran kontaminasi bakteri pada sirkuit pernapasan anestesi. Penelitian dilakukan dengan metode deskriptif observasional secara cross–sectional. Sebanyak 102 sampel dari 51 sirkuit pernapasan anestesi diperiksa kultur bakteri sebelum dan sesudah digunakan pada ruang operasi Rumah Sakit Dr. Hasan Sadikin Bandung selama 3 hari pada bulan Agustus 2015. Pengambilan sampel dilakukan dengan metode apus pada konektor Y sirkuit pernapasan anestesi sebelum dan sesudah digunakan dalam 24 jam. Hasil penelitian ini menunjukkan tidak ada kontaminasi bakteri pada sirkuit pernapasan anestesi sebelum digunakan pada ruang operasi Rumah Sakit Dr. Hasan Sadikin Bandung. Kontaminasi bakteri pada sirkuit pernapasan anestesi sesudah digunakan pada ruang operasi Rumah Sakit Dr. Hasan Sadikin Bandung adalah 25,49%. Gambaran pola bakteri yang teridentifikasi adalah bakteri Micrococcus spp., Bacillus spp., Streptococcus viridans, Serratia marcescens, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus hominis, dan Staphylococcus saprophyticus. Simpulan penelitian ini adalah tidak ditemukan kontaminasi bakteri pada sirkuit pernapasan anestesi sebelum digunakan dan ditemukan kontaminasi bakteri pada sirkuit pernapasan anestesi sesudah digunakan pada ruang operasi Rumah Sakit Dr. Hasan Sadikin Bandung.Kata kunci: Gambaran pola bakteri, kontaminasi bakteri, sirkuit pernapasan anestesi Description of Bacteria Contamination in Anesthesia Breathing Circuit in Operating Room Dr. Hasan Sadikin Bandung General Hospital in August 2015Breathing Circuits have been used repeatedly to perform anesthesia in the operating theater of Dr. Hasan Sadikin General Hospital with a replacement interval of every 24 hours. This study was conducted to determine the contamination of bacteria in the anesthesia Breathing Circuits. This was an observational descriptive cross–sectional study on 102 samples from 51 anesthesia Breathing Circuits. These samples were cultured before and after the use of Breathing Circuit in the operating room of Dr. Hasan Sadikin General Hospital for 3 days in August 2015. Sampling was performed using swab method at the Y connector of anesthesia Breathing Circuit before and after use within a period of 24 hours. The results showed that no bacterial contamination was found in the anesthesia Breathing Circuit before use in the operating theatre of Dr. Hasan Sadikin Hospital Bandung. Bacterial contamination of anesthesia Breathing Circuit after use was 25.49%. The bacteria identified were Micrococcus spp., Bacillus spp., Streptococcus viridans, Serratia marcescens, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus hominis and Staphylococcus saprophyticus. It is concluded that no bacterial contamination of anesthesia Breathing Circuit before use; however, bacterial contamination was found after the use of anesthesia Breathing Circuits in the operating theatre of Dr. Hasan Sadikin General Hospital Bandung.Key words: Anesthesia Breathing Circuits, bacterial contamination, description of the bacteria