{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:27:04Z","timestamp":1790720824340,"version":"4.1.0"},"reference-count":41,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T00:00:00Z","timestamp":1713571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Aerogen Ltd."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceutics"],"abstract":"<jats:p>High flow oxygen (HFO) therapy is a well-established treatment in respiratory disease. Concurrent aerosol delivery can greatly expediate their recovery. The aim of this work was to complete a comprehensive characterisation of one such HFO therapy system, the Airvo2TM, used in combination with the Aerogen SoloTM vibrating mesh nebuliser. Representative adult, infant, and paediatric head models were connected to a breathing simulator via a collection filter placed at the level of the trachea. A tracheostomy interface and nasal cannulas were used to deliver the aerosol. Cannula size and gas flow rate were varied across the full operating range recommended by the manufacturer. The tracheal and emitted doses were quantified via UV-spectrophotometry. The aerosol droplet diameter at the exit of the nares and tracheal interface was measured via cascade impaction. High gas flow rates resulted in low emitted and tracheal doses (%). Nasal cannula size had no significant effect on the tracheal dose (%) available in infant and paediatric models. Higher gas flow rates resulted in smaller aerosol droplets at the exit of the nares and tracheostomy interface. Gas flow rate was found to be the primary parameter affecting aerosol delivery. Thus, gas flow rates should be kept low and where possible, delivered using larger nasal cannulas to maximise aerosol delivery.<\/jats:p>","DOI":"10.3390\/pharmaceutics16040565","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T09:53:52Z","timestamp":1713779632000},"page":"565","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Performance Characterisation of the Airvo2TM Nebuliser Adapter in Combination with the Aerogen SoloTM Vibrating Mesh Nebuliser for in Line Aerosol Therapy during High Flow Nasal Oxygen Therapy"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3164-1607","authenticated-orcid":false,"given":"Ronan","family":"MacLoughlin","sequence":"first","affiliation":[{"name":"Research and Development, Science and Emerging Technologies, Aerogen Ltd., Galway Business Park, H91 HE94 Galway, Ireland"},{"name":"School of Pharmacy and Biomolecular Science, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland"},{"name":"School of Pharmacy and Pharmaceutical Sciences, Trinity College, D02 PN40 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0211-2132","authenticated-orcid":false,"given":"Marc","family":"Mac Giolla Eain","sequence":"additional","affiliation":[{"name":"Research and Development, Science and Emerging Technologies, Aerogen Ltd., Galway Business Park, H91 HE94 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/S2213-2600(20)30105-3","article-title":"Prevalence and attributable health burden of chronic respiratory diseases, 1990\u20132017: A systematic analysis for the Global Burden of Disease Study 2017","volume":"8","author":"Soriano","year":"2020","journal-title":"Lancet Respir. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1136\/thoraxjnl-2015-207962","article-title":"Nasal high flow oxygen therapy in patients with COPD reduces respiratory rate and tissue carbon dioxide while increasing tidal and end-expiratory lung volumes: A randomised crossover trial Research letter","volume":"71","author":"Fraser","year":"2016","journal-title":"Thorax"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1098427","DOI":"10.3389\/fmed.2022.1098427","article-title":"Aerosol delivery through high-flow nasal therapy: Technical issues and clinical benefits","volume":"9","author":"Calabrese","year":"2023","journal-title":"Front. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2301712","DOI":"10.1155\/2020\/2301712","article-title":"High-Flow Nasal Cannula: A Promising Oxygen Therapy for Patients with Severe Bronchial Asthma Complicated with Respiratory Failure","volume":"2020","author":"Geng","year":"2020","journal-title":"Can. Respir. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1183\/23120541.00724-2022","article-title":"Impact of high-and low-flow nebulised saline on airway hydration and mucociliary transport","volume":"9","author":"Kelly","year":"2023","journal-title":"ERJ Open Res."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Eain, M.M.G., and MacLoughlin, R. (2023). In-Line Aerosol Therapy via Nasal Cannula during Adult and Paediatric Normal, Obstructive, and Restrictive Breathing. Pharmaceutics, 15.","DOI":"10.3390\/pharmaceutics15122679"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4187\/respcare.09133","article-title":"The Impact of High-Flow Nasal Cannula Device, Nebulizer Type, and Placement on Trans-Nasal Aerosol Drug Delivery: An In Vitro Study","volume":"67","author":"Li","year":"2022","journal-title":"Respir. Care"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Li, J., Gong, L., and Fink, J.B. (2019). The ratio of nasal cannula gas flow to patient inspiratory flow on trans-nasal pulmonary aerosol delivery for adults: An in vitro study. Pharmaceutics, 11.","DOI":"10.3390\/pharmaceutics11050225"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1476","DOI":"10.4187\/respcare.02903","article-title":"Intermittent aerosol delivery to the lungs during high-flow nasal cannula therapy","volume":"59","author":"Golshahi","year":"2014","journal-title":"Respir. Care"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1089\/jamp.2011.0962","article-title":"Aerosol Delivery Through Tracheostomy Tubes: An in-vitro study","volume":"26","author":"Pitcane","year":"2013","journal-title":"J. Aerosol Med. Pulm. Drug Deliv."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"453","DOI":"10.4187\/respcare.06345","article-title":"Aerosol delivery through an adult high-flow nasal cannula circuit using low-flow oxygen","volume":"64","author":"Madney","year":"2019","journal-title":"Respir. Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1183\/23120541.00422-2020","article-title":"Aerosol delivery aspects within a high-flow therapy system in copd patients","volume":"7","author":"Madney","year":"2021","journal-title":"ERJ Open Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"9","DOI":"10.4187\/respcare.09242","article-title":"\u03b2 Agonist Delivery by High-Flow Nasal Cannula During COPD Exacerbation: A Prospective Physiological Study","volume":"67","author":"Beuvon","year":"2022","journal-title":"Respir. Care"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1089\/jamp.2017.1366","article-title":"Aerosol Delivery with Two Nebulizers Through High-Flow Nasal Cannula: A Randomized Cross-Over Single-Photon Emission Computed Tomography-Computed Tomography Study","volume":"30","author":"Dugernier","year":"2017","journal-title":"J. Aerosol Med. Pulm. Drug Deliv."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.4187\/respcare.01518","article-title":"Survey of aerosol delivery techniques to spontaneously breathing tracheostomized children","volume":"57","author":"Berlinski","year":"2012","journal-title":"Respir. Care"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Li, J., Fink, J.B., MacLoughlin, R., and Dhand, R. (2020). A narrative review on trans-nasal pulmonary aerosol delivery. Crit. Care, 24.","DOI":"10.1186\/s13054-020-03206-9"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/s41030-018-0054-x","article-title":"In Vitro Determination of the Main Effects in the Design of High-Flow Nasal Therapy Systems with Respect to Aerosol Performance","volume":"4","author":"Bennett","year":"2018","journal-title":"Pulm. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Murphy, B., Eain, M.M.G., Joyce, M., Fink, J.B., and MacLoughlin, R. (2022). Evaluation of aerosol drug delivery with concurrent low and high flow nasal oxygen. ERJ Open Res., 8.","DOI":"10.1183\/23120541.00220-2022"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s41030-019-0086-x","article-title":"In Vitro Study of the Effect of Breathing Pattern on Aerosol Delivery during High-Flow Nasal Therapy","volume":"5","author":"Bennett","year":"2019","journal-title":"Pulm. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1002\/ppul.26270","article-title":"Aerosol delivery in models of pediatric high flow nasal oxygen and mechanical ventilation","volume":"58","author":"Wang","year":"2023","journal-title":"Pediatr. Pulmonol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1002\/ppul.23509","article-title":"Nasal high flow nebulization in infants and toddlers: An in vitro and in vivo scintigraphic study","volume":"52","author":"Vecellio","year":"2017","journal-title":"Pediatr. Pulmonol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.prrv.2006.06.004","article-title":"Indications for tracheostomy in children","volume":"7","author":"Trachsel","year":"2006","journal-title":"Paediatr. Respir. Rev."},{"key":"ref_23","first-page":"636","article-title":"Special problems in aerosol delivery: Artificial airways","volume":"45","author":"Dhand","year":"2000","journal-title":"Respir. Care"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.4187\/respcare.01167","article-title":"An in vitro evaluation of aerosol delivery through tracheostomy and endotracheal tubes using different interfaces","volume":"57","author":"Ari","year":"2012","journal-title":"Respir. Care"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.4187\/respcare.03592","article-title":"Effect of aerosol devices and administration techniques on drug delivery in a simulated spontaneously breathing pediatric tracheostomy model","volume":"60","author":"Alhamad","year":"2015","journal-title":"Respir. Care"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1056\/NEJMoa052052","article-title":"Lung Recruitment in Patients with the Acute Respiratory Distress Syndrome","volume":"354","author":"Gattinoni","year":"2006","journal-title":"N. Engl. J. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.4187\/respcare.03449","article-title":"Comparison of aerosol delivery by face mask and tracheostomy collar","volume":"60","author":"Bugis","year":"2015","journal-title":"Respir. Care"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"173","DOI":"10.4187\/respcare.09673","article-title":"Factors Associated With Accidental Decannulation in Tracheostomized Children","volume":"68","author":"Villarroel","year":"2023","journal-title":"Respir. Care"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1089\/089426804322994460","article-title":"Determining Factors of Aerosol Deposition for Four pMDI-Spacer Combinations in an Infant Upper Airway Model","volume":"17","author":"Janssens","year":"2004","journal-title":"J. Aerosol. Med."},{"key":"ref_30","unstructured":"(2013). Anaesthetic and Respiratory Equipment\u2014Nebulizing Systems and Components (Standard No. ISO27427). Available online: https:\/\/www.iso.org\/standard\/59482.html."},{"key":"ref_31","unstructured":"Pharmacopoeia, E. Inhalation: Aerodynamic assessment of fine particles Fine particle dose and particle size distribution. Connect, 2005."},{"key":"ref_32","unstructured":"(2023, September 07). USP 1601 Products for Nebulisation\u2014Characterisation Tests. Available online: https:\/\/doi.usp.org\/USPNF\/USPNF_M4347_03_01.html."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.4187\/respcare.05127","article-title":"Aerosol delivery through adult high flow nasal cannula with heliox and oxygen","volume":"62","author":"Dailey","year":"2017","journal-title":"Respir. Care"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e250","DOI":"10.1097\/PCC.0b013e31828a7f79","article-title":"Influences of cannula size and flow rate on aerosol drug delivery through the Vapotherm humidified high-flow nasal cannula system","volume":"14","author":"Perry","year":"2013","journal-title":"Pediatr. Crit. Care Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1080\/02786826.2014.954029","article-title":"Development of a transient flow aerosol mixer-heater system for lung delivery of nasally administered aerosols using a nasal cannula","volume":"48","author":"Golshahi","year":"2014","journal-title":"Aerosol Sci. Technol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Li, J., Chen, Y., Ehrmann, S., Wu, J., and Xie, L. (2021). Bronchodilator Delivery via High-Flow Nasal Cannula: A Randomized Controlled Trial to Compare the Effects of Gas Flows. Pharmaceutics, 13.","DOI":"10.3390\/pharmaceutics13101655"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"894","DOI":"10.4187\/respcare.05961","article-title":"High-flow nasal cannula in pediatric patients: A survey of clinical practice","volume":"63","author":"Miller","year":"2018","journal-title":"Respir. Care"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1002\/ppul.24326","article-title":"Deposition studies of aerosol delivery by nasal cannula to infants","volume":"54","author":"Corcoran","year":"2019","journal-title":"Pediatr. Pulmonol."},{"key":"ref_39","first-page":"699","article-title":"Aerosol delivery devices in the treatment of asthma","volume":"53","author":"Hess","year":"2008","journal-title":"Respir. Care"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1081\/DDC-120039213","article-title":"Influence of the size of micronized active pharmaceutical ingredient on the aerodynamic particle size and stability of a metered dose inhaler","volume":"30","author":"Berry","year":"2004","journal-title":"Drug Dev. Ind. Pharm."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1089\/jamp.2007.0662","article-title":"Aerosol delivery through nasal cannulas: An in vitro study","volume":"21","author":"Bhashyam","year":"2008","journal-title":"J. Aerosol Med. Pulm. Drug Deliv."}],"container-title":["Pharmaceutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4923\/16\/4\/565\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:31:43Z","timestamp":1760106703000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4923\/16\/4\/565"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,20]]},"references-count":41,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["pharmaceutics16040565"],"URL":"https:\/\/doi.org\/10.3390\/pharmaceutics16040565","relation":{},"ISSN":["1999-4923"],"issn-type":[{"value":"1999-4923","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,20]]}}}