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Effect of continuous positive airway pressure combined to nebulization on lung deposition measured by urinary excretion of amikacin.

Authors :
Reychler, Gregory
Leal, Teresinha
Roeseler, Jean
Thys, Frédéric
Delvau, Nicolas
Liistro, Giuseppe
Source :
Respiratory Medicine; Oct2007, Vol. 101 Issue 10, p2051-2055, 5p
Publication Year :
2007

Abstract

Summary: Continuous positive airway pressure (CPAP) is frequently used in patients attending emergency units. Its combination with nebulization is sometimes necessary in those patients presenting with a CPAP dependency. Study objective: To compare lung deposition of amikacin delivered by a classical jet nebulizer (SideStream; Medic-Aid; West Sussex, UK) used alone (SST) or coupled to a CPAP device (Boussignac; Vygon; Belgium). Method: Amikacin (1g) was nebulized with both devices in six healthy subjects during 5min on spontaneous breathing. A 1-week wash-out period between each nebulization was applied. Lung deposition was indirectly assessed by urinary monitoring of excreted amount of amikacin. Results: Total daily amount of amikacin excreted in the urine was significantly lower with CPAP than with SST (1.97% initial dose versus 4.88% initial dose, p<0.001) with a corresponding mean ratio CPAP/SST of 0.41. The residual amount of amikacin in the nebulizer was higher with CPAP than with SST (607mg versus 541mg) but the difference was not significant (p=0.35). Conclusion: These data suggest that the amount of amikacin delivered to healthy lungs is 2.5-fold lower with CPAP than with SST for the same nebulization time and that the nebulization time when using CPAP should be increased to reach the same amount of drug delivered with a classical jet nebulizer. [Copyright &y& Elsevier]

Details

Language :
English
ISSN :
09546111
Volume :
101
Issue :
10
Database :
Supplemental Index
Journal :
Respiratory Medicine
Publication Type :
Academic Journal
Accession number :
26415950
Full Text :
https://doi.org/10.1016/j.rmed.2007.06.003