final aerogen
TRANSCRIPT
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AEROGEN – The art of nebulization
VA Palo Alto Hospital
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What is aerogen?
• High efficiency vibrating mesh aerosol drug delivery system
• Inline or stand alone
Aerogen is the company
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When do we use ithere at the VA?
• Unit dose medication – 1. Mech. Ventilator (in-
line) 2. V60• Continuous aerosol -
Flolan• Transport – ambu bag
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How does it benefits us?
• Contamination Risk• Drug deposition- high quality• No additional flow to system – does not trigger vent alarms• Cost Reduction – monthly• 22% Decrease in LOS in ICU• Improve staff satisfaction• All medications (including abx, mucomyst)Note: rinse with couple of drops of NaCl- clears the pores
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Comparison of Aerogen to MDI
Economical drug delivery, savings verses MDI
Easy to operatePropellant freeDelivers more drug per dose
•High cost per canister•Technique dependent – timed with inspiration•HFA propellants•Delivers less drug per dose
Aerogen MDI
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comparison of Aerogen to standard nebs
9 times more drug deposition than SVN
No flow added to the circuitReduction in time to deliver meds – 7.5mg continuous neb cut from 1-hour to 8-minutes
Faster patient response
Drug waste – residual volume 0.8 -1.2ml
Adds flow requiring changes in vent parameters
Re nebulizes condensateContamination risks
Aerogen Standard nebulizer
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Efficiency Studies
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Set Up
• V500• LTV
Drager XL is retiring!!
Filter! Filter!
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Set up on NIV(Mask)
V60
Position #2
Not here!
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Aerogen-V60 Set up on patient
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Flolan set up-Before-
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Flolan Set up -after-
Dual Pump or syringe?
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Trouble shooting
RIGHT
WRONG
Check:•Connections•Power Source•Position 1.Adaptor2.Aerogen
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Transport
During Flolan transport
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Future:Continuous Neb in ED and HFNC
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Why in ED?
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Policy and procedure
• Please see VA policy procedure manual book.• Respiratory Department
• Also check out Aerogen handbook for more detailed information!
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How to use it?(Set up)
DEMO TIME!
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The END
1.) Clinical White Paper document “Aerogen, Pioneering Aerosol Drug Delivery”, Retrieved (2016, October 31) from www.aerogen.com Dangan, Galway Ireland, Aerogen Ltd.2.) Power Point presentation “The Art of Nebulization” by: Peter Kahane CRT, RCP, AE-C, Retrieved (2016, October 30)
3.) PubMed Article, from Nih.gov “Performance Comparisons of Jet and Mesh Nebulizers Using Different Interfaces in Simulated Spontaneously Breathing Adults and Children”, retrived (2016, October 31) from https://www.ncbi.nlm.nih.gov/pubmed/25493535
Questions?
References:
Special thanks to: Byron Shipp for the policy and procedures.