Dataset Information

Modified Small-Volume Jet Nebulizer Based on CFD Simulation and Its Clinical Outcomes in Small Asthmatic Children.

ABSTRACT: The small-volume jet nebulizer (SVJN) is an aerosol device used to treat respiratory illnesses. Major problems for aerosol treatment in small children include the penetration of particles to the lower lungs due to irregular and small volume of a child patient's breath while the nebulizers used are the same models intended for adults. This adult SVJN produces a huge number of particles at a higher speed than small children can intake. To solve this problem, computational fluid dynamics (CFD) was used to redesign the device by adding 6-inch corrugated tube with 80?ml capacity (equal to one inhale capacity of a small child) into the traditional SVJN. Results revealed that the undulations of the corrugated tube were the important parts that change the direction of aerosol flow, slowing down the produced speed of aerosol up to 31.48% (mean speed?=?0.37?m/s via modified SVJN vs 0.54?m/s via traditional which were close to measured results). The modified SVJN was tested for the effectiveness on how it could accommodate bronchodilator drug to the lower lungs by 3 clinical researches with 238 asthmatic children aged 1-5?years. The results revealed that the experimental group reported higher bronchodilatating effects: higher mean score of change in oxygen saturation and degree of wheezing and greater reduction in respiratory rate per minute than the control group with statistical difference (p < 0.05). Meanwhile, heart rate and physical attributes (dead volume and duration of aerosol treatment) were indifferent. Moreover, small children showed more acceptance behavior towards this modified SVJN than the traditional one. Modified SVJN might be a good choice for aerosol treatment in small children because it slows down the speed of aerosol production, makes them well spread all over the reservoir, and is ready for small children to inhale for better clinical outcomes while physical attributes are the same.

SUBMITTER: Santati S

PROVIDER: S-EPMC6590536 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Modified Small-Volume Jet Nebulizer Based on CFD Simulation and Its Clinical Outcomes in Small Asthmatic Children.

Santati Sermsri S Thongsri Jatuporn J Sarntima Parinya P

Journal of healthcare engineering 20190610

The small-volume jet nebulizer (SVJN) is an aerosol device used to treat respiratory illnesses. Major problems for aerosol treatment in small children include the penetration of particles to the lower lungs due to irregular and small volume of a child patient's breath while the nebulizers used are the same models intended for adults. This adult SVJN produces a huge number of particles at a higher speed than small children can intake. To solve this problem, computational fluid dynamics (CFD) was ...[more]

PMID: 31281613

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Project description:Experimental infection of animals with aerosols containing pathogenic agents is essential for an understanding of the natural history and pathogenesis of infectious disease as well as evaluation of potential treatments. We evaluated whether the Aeroneb nebulizer, a vibrating mesh nebulizer, would serve as an alternative to the Collison nebulizer, the "gold standard" for generating infectious bioaerosols. While the Collison possesses desirable properties that have contributed to its longevity in infectious disease aerobiology, concerns have lingered about the liquid volume and concentration of the infectious agent required to cause disease and the damage that jet nebulization causes to the agent. Fluorescein salt was added to the nebulizer contents to assess pathogen loss during aerosolization. Relative to fluorescein salt, loss of influenza virus during aerosolization was worse with the Collison than with the Aeroneb. Four other viruses also had superior aerosol performance with the Aeroneb. The Aeroneb did not improve the aerosol performance for a vegetative bacterium, Francisella tularensis Environmental parameters collected during the aerosol challenges indicated that the Aeroneb generated a higher relative humidity in exposure chambers while not affecting other environmental parameters. The aerosol mass median aerodynamic diameter (MMAD) was generally larger and more disperse for aerosols generated by the Aeroneb than what is seen with the Collison, but ≥80% of particles were within the range that would reach the lower respiratory tract and alveolar regions. The improved aerosol performance and generated particle size range suggest that for viral pathogens, the Aeroneb is a suitable alternative to the Collison three-jet nebulizer for use in experimental infection of animals.IMPORTANCE Respiratory infection by pathogens via aerosol remains a major concern for both natural disease transmission as well as intentional release of biological weapons. Critical to understanding the disease course and pathogenesis of inhaled pathogens are studies in animal models conducted under tightly controlled experimental settings, including the inhaled dose. The route of administration, particle size, and dose can affect disease progression and outcome. Damage to or loss of pathogens during aerosolization could increase the dose required to cause disease and could stimulate innate immune responses, altering outcome. Aerosol generators that reduce pathogen loss would be ideal. This study compares two aerosol generators to determine which is superior for animal studies. Aerosol research methods and equipment need to be well characterized to optimize the development of animal models for respiratory pathogens, including bioterrorism agents. This information will be critical for pivotal efficacy studies in animals to evaluate potential vaccines or treatments against these agents.

Project description:BackgroundSmall airways are the major sites of inflammation and airway remodeling in all severities of asthma patients. However, whether small airway function parameters could reflect the airway dysfunction feature in preschool asthmatic children remain unclear. We aim to investigate the role of small airway function parameters in evaluating airway dysfunction, airflow limitation and airway hyperresponsiveness (AHR).MethodsEight hundred and fifty-one preschool children diagnosed with asthma were enrolled retrospectively to investigate the characteristics of small airway function parameters. Curve estimation analysis was applied to clarify the correlation between small and large airway dysfunction. Spearman's correlation and receiver-operating characteristic (ROC) curves were employed to evaluate the relationship between small airway dysfunction (SAD) and AHR.ResultsThe prevalence of SAD was 19.5% (166 of 851) in this cross-sectional cohort study. Small airway function parameters (FEF25-75%, FEF50%, FEF75%) showed strong correlations with FEV1% (r = 0.670, 0.658, 0.609, p<0.001, respectively), FEV1/FVC% (r = 0.812, 0.751, 0.871, p<0.001, respectively) and PEF% (r = 0.626, 0.635, 0.530, p<0.01, respectively). Moreover, small airway function parameters and large airway function parameters (FEV1%, FEV1/FVC%, PEF%) were curve-associated rather than linear-related (p<0.001). FEF25-75%, FEF50%, FEF75% and FEV1% demonstrated a positive correlation with PC20 (r = 0.282, 0.291, 0.251, 0.224, p<0.001, respectively). Interestingly, FEF25-75% and FEF50% exhibited a higher correlation coefficient with PC20 than FEV1% (0.282 vs. 0.224, p = 0.031 and 0.291 vs. 0.224, p = 0.014, respectively). ROC curve analysis for predicting moderate to severe AHR showed that the area under the curve (AUC) was 0.796, 0.783, 0.738, and 0.802 for FEF25-75%, FEF50%, FEF75%, and the combination of FEF25-75% and FEF75%, respectively. When Compared to children with normal lung function, patients with SAD were slightly older, more likely to have a family history of asthma and airflow obstruction with lower FEV1% and FEV1/FVC%, lower PEF% and more severe AHR with lower PC20 ( all p<0.05).ConclusionSmall airway dysfunction is highly correlated with large airway function impairment, severe airflow obstruction and AHR in preschool asthmatic children. Small airway function parameters should be utilized in the management of preschool asthma.

Dataset Information

Modified Small-Volume Jet Nebulizer Based on CFD Simulation and Its Clinical Outcomes in Small Asthmatic Children.

Publications

Modified Small-Volume Jet Nebulizer Based on CFD Simulation and Its Clinical Outcomes in Small Asthmatic Children.

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