Fugitive Emissions from a Breath Actuated Jet Nebuliser and a Vibrating Mesh Nebuliser for a Paediatric Patient

摘要

Introduction Recent studies have identified the potential for fugitive emissions to be released during nebulisation treatments. Here we quantify fugitive emissions from a commercially available breath actuated compressor driven jet nebuliser (JN) designed to reduce emissions, and a vibrating mesh nebuliser (VMN) and valved spacer. Methodology A breath actuated jet nebuliser with a mouthpiece (Aeroeclipse2, Monaghan Medical, Canada) was operated at 8 L/min. Two modes on the nebuliser were tested during simulated paediatric breathing (Vt 250 mL, breath rate 25 BPM, l:E ratio 1:2); breath-actuated nebulisation (BAN) and continuous nebulisation (CN) (n = 5). A vibrating mesh nebuliser (VMN) (Aerogen Solo with Aerogen Ultra, Aerogen, Galway, Ireland) was used with a mouthpiece in CN mode only. A standard prescription dose of 3 mL of 2 mg/mL salbutamol was nebulised. An Aerodynamic Particle Sizer (TSI Inc., US) placed at 0.8 m (arm's length) from the nebuliser was used to characterise the fugitive aerosol concentration (mg drug/m~3) over a 45 minute period. Results Fugitive emissions were released during nebulisation treatment for both nebuliser types and both modes. CN mode on the jet nebuliser had a higher fugitive aerosol concentration of 0.061 ± 0.048 mg/m~3 compared to the BAN and the VMN (0.044 ± 0.030 mg/m~3 and 0.011 ± 0.006 mg/m3). MMAD averaged 1.21 ± 0.05 for JN CN, 1.22 ± 0.04 for JN BAN and 1.20 ± 0.12 pm for VMN. Conclusion The results confirm that fugitive emissions are released into the surrounding environment during respiratory therapy using both CN and BAN mode on the jet nebuliser as well as CN mode for the vibrating mesh nebuliser. However, across all tests, the vibrating mesh nebuliser in combination with a valved spacer recorded the lowest secondary emissions.