{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T06:39:08Z","timestamp":1782801548954,"version":"3.54.5"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T00:00:00Z","timestamp":1553731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Trans\u2010nasal pulmonary aerosol delivery for infants and toddlers has recently gained popularity, however, the reported lung deposition is low. We aimed to investigate the influential factors to improve the delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Anatomic airway manikins simulating infant (5\u2009kg) and toddler (15\u2009kg) with collecting filter connected the trachea and breath simulator, were set to represent quiet and distressed breathing. Nasal cannula flow was set at 0.125, 0.25, 0.5, 1, and 2\u2009L\/kg\/min. A mesh nebulizer (Aerogen) was placed at the inlet of humidifier (Fisher &amp; Paykel) and proximal to patient. Albuterol (5\u2009mg in 1\u2009mL) was nebulized for each condition (<jats:italic>n<\/jats:italic>\u2009=\u20093). Drug was eluted from the filter and assayed with UV spectrophotometry (276\u2009nm).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Inhaled dose was higher with nebulizer placed at the inlet of humidifier than proximal to patient in all settings, except the infant model at low gas flow settings (0.125 and 0.25\u2009L\/kg\/min). When nebulizer was placed at the inlet of humidifier, inhaled dose was higher when gas flow was below patient's inspiratory flow than when gas flow exceeded patient's inspiratory flow (8.77\u2009\u00b1\u20093.84 vs 2.16\u2009\u00b1\u20091.29%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001); aerosol deposition increased as gas flow decreased, with greatest deposition at gas flow of 0.25\u2009L\/kg\/min (11.29\u2009\u00b1\u20092.15%). A multiple linear regression identified gas flow as the primary predictor of aerosol delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Trans\u2010nasal pulmonary aerosol delivery was significantly improved when gas flow was below patient's inspiratory flow, aerosol deposition increased with decreased nasal cannula flow, with greatest deposition at 0.25\u2009L\/kg\/min.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.24274","type":"journal-article","created":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T13:13:48Z","timestamp":1553778828000},"page":"914-921","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Decrease the flow setting to improve trans\u2010nasal pulmonary aerosol delivery via \u201chigh\u2010flow nasal cannula\u201d to infants and toddlers"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0121-1291","authenticated-orcid":false,"given":"Jie","family":"Li","sequence":"first","affiliation":[{"name":"Department of Cardiopulmonary Sciences Division of Respiratory Care Rush University Medical Center Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingyue","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Cardiopulmonary Sciences Division of Respiratory Care Rush University Medical Center Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arzu","family":"Ari","sequence":"additional","affiliation":[{"name":"Department of Respiratory Care College of Health Professions Texas State University Round Rock Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James B.","family":"Fink","sequence":"additional","affiliation":[{"name":"Department of Cardiopulmonary Sciences Division of Respiratory Care Rush University Medical Center Chicago Illinois"},{"name":"Aerogen Pharma Corp San Mateo California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2014-306590"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-012-2743-5"},{"key":"e_1_2_9_4_1","first-page":"CD006405","article-title":"High flow nasal cannula for respiratory support in preterm infants","volume":"22","author":"Wilkinson D","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-018-2080-3"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60249-5"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-013-2139-8"},{"key":"e_1_2_9_8_1","unstructured":"Ministry of Health in New South Wales Australia. Humidified high flow nasal cannula oxygen guideline for metropolitan paediatric wards and EDs:http:\/\/www1.health.nsw.gov.au\/pds\/ActivePDSDocuments\/GL2016_004.pdf. Accessed by Nov 15th 2018."},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.03996"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05880"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23509"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-017-0278-1"},{"key":"e_1_2_9_13_1","first-page":"945","article-title":"Aerosol therapy through high flow nasal cannula in pediatric patients","volume":"11","author":"Al\u2010Subu AM","year":"2017","journal-title":"Expert Rev Respir Med"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.2174\/1389201019666171219104217"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05961"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/jamp.2007.0662"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.21421"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e31828a7f79"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23123"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.06.006"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05728"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30061-2"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijccm.IJCCM_274_17"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.06.077"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2017.24"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1086\/685080"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1089\/jamp.2015.1219"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05127"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1586\/17476348.2013.847369"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fppul.24274","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.24274","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.24274","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.24274","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T13:43:03Z","timestamp":1694353383000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.24274"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,28]]},"references-count":28,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1002\/ppul.24274"],"URL":"https:\/\/doi.org\/10.1002\/ppul.24274","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,28]]},"assertion":[{"value":"2018-11-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}