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Vol. 46. Issue 5.
Pages 230-237 (May 2010)
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Vol. 46. Issue 5.
Pages 230-237 (May 2010)
Original Article
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Increased Inspiratory Oxygen Fractions (FIO2) Using a Conventional Drug Delivery Nebuliser
Fracciones inspiratorias elevadas de O2 con el uso del dispositivo convencional de nebulización de fármacos
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Joaquim Geaa,b,
Corresponding author
jgea@imim.es

Corresponding author.
, Mauricio Orozco-Levia,b, Lluís Gallartc
a Servicio de Neumología, Hospital del Mar, Instituto Municipal de Investigación Médica (IMIM), Universitat Pompeu Fabra, Barcelona, Spain
b Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Bunyola, Baleares, Spain
c Servicio de Anestesia, Hospital del Mar–IMIM, Universidad Autónoma de Barcelona, Barcelona, Spain
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Article information
Abstract

Nebulised drugs are very useful in COPD exacerbations. The most frequently used propellant is compressed air, which is commonly administered together with nasal oxygen in those patients with respiratory failure. The purpose of this approach is to avoid the risks inherent in breathing high inspiratory oxygen fractions (FIO2).

Aim

To analyze the actual FIO2 obtained with such a common method under experimental conditions.

Methods

Volunteers breathed using different patterns (quiet breathing, panting and deep breathing), through either the nose or the mouth, with oxygen flows of 0 vs. 4l/min. Then, they repeated quiet breathing and panting patterns, with nebulisation of saline propelled by compressed air (8l/min) and oxygen flows of 0, 2, 4, 6 and 8l/min. The FIO2 was simultaneously determined both in retronasal (RN) and retropharyngeal (RF) areas.

Results

During breathing without simultaneous nebulisation and oxygen flow of 4l/min, FIO2 reached mean values of 0.42–.71 (RN) and 0.29–.38 (RF) for the three ventilatory patterns analyzed. With nebulisations during quiet breathing, mean FIO2 values were 0.39 (RN) and 0.27 (RF) for 2l/min O2 flow, 0.47 (RN), 0.34 (RF) for 4l/min, 0.58 (RN), 0.38 (RF) for 6l/min, and 0.68 (RN) and 0.50 (RF) for 8l/min. Similar results were obtained with the panting pattern.

Conclusion

The FIO2 obtained using the conventional nebulisation system (propulsion with compressed air and simultaneous nasal oxygen therapy) are relatively high, and therefore, might involve risks for COPD patients during exacerbations.

Keywords:
Nebulisations
Hypoventilation
Oxygen therapy
Resumen

Los fármacos nebulizados son de gran utilidad en el tratamiento de las agudizaciones de la EPOC. El gas propulsor más utilizado es aire comprimido, que suele combinarse con oxigenoterapia por vía nasal en pacientes con insuficiencia respiratoria. Este método pretende evitar los riesgos inherentes a la inhalación de fracciones inspiratorias de oxígeno (FIO2) elevadas.

Objetivo

Analizar experimentalmente las FIO2 reales obtenidas mediante el dispositivo mencionado.

Método

Los voluntarios respiraron con diversos patrones (basal, jadeo y respiración profunda) por vías nasal u oral y a flujos de oxígeno de 0–4 l/min. Seguidamente, repitieron los patrones basal y de jadeo con nebulización de suero salino impulsada por aire comprimido (8 l/min) y flujos de oxígeno nasales de 0, 2, 4, 6 y 8 l/min. La FIO2 se determinó en regiones retronasal (RN) y retrofaríngea (RF).

Resultados

Durante la respiración sin nebulización simultánea y O2 a 4 l/min, la FIO2 alcanzó valores medios de 0,42–,71 (RN) y 0,29–0,38 (RF) para los 3 patrones analizados. Durante la nebulización con salino y en respiración tranquila, los valores medios de FIO2 fueron de 0,39 (RN) y 0,27 (RF) para O2 a 2 l/min, 0,47 (RN) y 0,34 (RF) para 4 l/min, 0,58 (RN) y 0,38 (RF) para 6 l/min y 0,68 (RN) y 0,50 (RF) para 8 l/min. Cifras similares se alcanzaron con patrón de jadeo.

Conclusión

Las FIO2 obtenidas mediante el sistema estándar de nebulización con aire comprimido y oxigenoterapia simultánea son relativamente elevadas y pudieran suponer un riesgo para los pacientes con EPOC exacerbada.

Palabras clave:
Nebulizaciones
Hipoventilación
Oxigenoterapia
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