Assessment of a Ventilator Circuit Adapter to be Used in Conjunction with the Respimat† Soft Mist Inhaler

RAtIonAle•WiththeintroductionoftheRespimat†SoftMistInhaler(SMI)thereisadesireforanadaptertoallowitsuseinventilatorcircuits.Anadapter(RespiConnect*Adapter)wasassessedintermsofdrugdeliveryandsafetyfeatures.

•Patientsonmechanicalventilationeitherinvolvingprophylacticdeliveryofbronchodilators,orreceivingsuchmedicationtotreatasevereCOPDexacerbationmayneedcontinuoustherapy

Excellence By Design

J. Suggett, M. NagelTrudellMedicalInternational,London,Canada.

MD-800A-0717.*trade-marksandregisteredtrade-marksofTrudellMedicalInternational.†trade-marksandregisteredtrade-marksofBoehringerIngelheim.Copyright©TrudellMedicalInternational2017.

ERS International Congress Milan, Italy

September 9 – 13, 2017

MethodS•Eachadapter(n=10)wasinsertedintheinspiratorylimbofaheatedadultventilatorcircuit

•A7.0mmEndotrachealTube(ET)wasattachedtoafilterandthedistalsideofthefiltercoupledtoanadulttestlungtosimulateapatient

•AServoventilator(SV900C,Siemens,Sweden)deliveredtherequiredbreathingpattern:

•tidalvolume(Vt)=600mL

•10breaths/minute

•Inspiratory/expiratory(I/E)ratio=1:3

•5cmH2OPositiveEndExpiratoryPressure(PEEP)

ReSUltS•Duringtheexperimentthecircuitdidnotlosepressureandnoalarmsweretriggered,indicatingthattheselfsealingvalvewaseffective

•Meanvaluesof30.3%and29.4%LCweredeterminedforSALandIPRrespectively

ConClUSIonS•Itisknownthatnothavingagoodconsistentsealcanjeopardizethesafetyofthepatientthroughcircuitleakagesandaconsistentsealisalsoneededinordertoachieveadequatedrugdeliverytothepatient

•thepresenceofaself-sealingvalveandsafetycapfortheRespiConnect*Adaptershouldensureventilatorcircuitintegrityandthereforealsohelpprotectthesafetyofthepatient

•Approximately30%LCofbothdrugcomponentsintheSMIwasdeliveredtothedistalendofETtubeviatheadapter

•thisstudyprovidescliniciansassuranceregardingcircuitintegrityandlikelydrugdeliveryperformancewhenusingtheRespiConnect*Adapter

•Aventilatorcircuithumidifier(modelMR50JHU,Fischer-Paykel,Auckland,NZ)wasusedtomaintainconditionsclosetobodytemperatureandsaturationwithwatervapour

•FiveactuationsofCombivent†SMIweredelivered,eachactuationfollowedby6completebreathingcycles

•BetweenactuationstheSMIwasremovedfromtheadapterandprimedaccordingtomanufacturer’sinstructions

•Salbutamol(SAL)andIpratropium(IPR)wererecoveredfromthefilterandquantifiedbyHPLCas%LabelClaim(LC)

StUdY PURPoSe•theRespiConnect*Adapterwasdesignedforsafetyandmechanicalperformance

•theself-sealingmechanicalvalvemaintainstheintegrityoftheventilatorcircuitatalltimes;aredundantcapisincorporatedforextrasafety

•thisstudyassessedmechanicalperformancethroughitsabilitytoretaincircuitintegrityaswellasaerosoldrugdeliveryinaventilator

RespiConnect*AdapterTrudell Medical International London, Canada

RespiConnect*AdapterwithRespimat†SMI

Experimental Lab Set-up

Flow pattern of RespiConnect* Adapter with RespiConnect† SMI engaged

•AerosoldeliverywasoptimizedthroughCFDanalysisduringadapterdesign

Servo ventilator

Inhalation (humidified air)

Respimat† SMI

RespConnect* Adapter

Wye connector

ET Filter

Adult test lung

Circuit humidifierExhalation

Drug In

Air + Drug Out Air Out