Delivery of Nebulised Drugs using Endotracheal Tube

The purpose of the studies was to estimate efficiency of delivering nebulised drugs into the lower respiratory tract through endotracheal tubes (ET tubes) which are commonly used in the treatment of uncooperative patients. Water solution of Disodium Cromoglycate (DSCG) was nebulised with a constant air flow (25 l/min). Experimental studies were done for eight ET tubes with varying sizes (internal diameter, length) and made of two different materials. Size distribution of aerosol leaving ET tubes was determined with the use of aerosol spectrometer. Fine Particle Fraction (FPF) and Mass Median Aerodynamic Diameter (MMAD) were calculated for the aerosol leaving each tube. Additionally, mass of the Disodium Cromoglycate deposited into each endotracheal tube was determined. ET tubes can significantly influence the parameters of delivered aerosol depending on their diameter. FPF of aerosol delivered in to the respiratory tract is lower if small endotracheal tubes are used. However, MMAD and FPF for large endotracheal tubes are almost identical with MMAD and FPF from nebuliser. The results indicate that a substantial fraction of large droplets is eliminated from the aerosol stream in long endotracheal tubes (270 mm). In this case the mass of drug delivered through ET tubes is reduced but the content of small droplets increases (high value of FPF).