• Takashi Karashima, Yuka Mimura-Kimura, Kanade Miyakawa, Akihiro Nakamura, Fuminori Shimahara, Haruhito Kamei, and Yusuke Mimura.
• Department of Medical Engineering, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan.
• Respir Care. 2019 May 1; 64 (5): 502-508.

BackgroundIntrapulmonary percussive ventilation (IPV) is used for airway clearance and delivery of aerosol medications, including bronchodilators. Despite the common use of IPV for drug delivery, few data are available regarding optimization of inhalation therapy with IPV. In this study, we investigated the influence of IPV setting parameters and lung mechanics on drug delivery via IPV alone.MethodsAn IPV device was connected to a lung model via a trachea model and a flow analyzer. Albuterol nebulized from the IPV device was collected onto a filter attached between the trachea and lung models, and was quantitated by spectrophotometry (230 nm).ResultsAlbuterol delivery to the lung model was increased up to 2.1-fold, with decreasing percussion frequency. Decreasing percussion frequency concomitantly increased the tidal volume, and albuterol delivery was correlated with tidal volume (r = 0.91, P < .001). Airway resistance had a negative impact on albuterol delivery, whereas lung compliance had no significant effect. Increasing operational pressure increased albuterol delivery while increasing peak inspiratory pressure.ConclusionsAlbuterol delivery and tidal volume with IPV can be improved by maintaining low levels of percussion frequency and increasing operational pressure. When increasing operational pressure, the peak inspiratory pressure and airway resistance levels need to be carefully monitored for safe inhalation therapy with IPV.Copyright © 2019 by Daedalus Enterprises.

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