COVID-19 & Aerogen

Aerogen can help to mitigate the release of fugitive aerosols during nebulisation

The latest GOLD Report1 states that for COVID-19 patients receiving ventilatory support …

…it is vital to keep the circuit intact and prevent the transmission of the virus. Using a mesh nebulizer in ventilated patients allows the addition of medication without requiring the circuit to be broken for aerosol drug delivery…


Aerogen is a closed-circuit drug delivery system,2,3 which can help mitigate the release of fugitive aerosols during nebulisation†2, 4-6

The need to open a pressurised ventilator circuit to administer aerosolised medication is considered a potential risk factor for the release of fugitive aerosol.†2,7,8

In studies, the use of Aerogen vibrating mesh nebulisers was associated with lower fugitive aerosol emissions versus jet nebulisers during invasive mechanical ventilation (IMV),‡2 high-flow (HF),§6 and when self-ventilating (SV).﹟4,¶5

 

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Invasive mechanical ventilation, Aerogen closed-circuit aerosol drug delivery system

Aerogen, your solution to delivering inhaled medication to patients with COVID-19.

Closed-circuit aerosol drug delivery

Aerogen is a closed-circuit aerosol drug delivery system,2,3 which can help mitigate the release of fugitive aerosols during nebulisation.†2,4-6 



Effectiveness

Aerogen facilitates effective medication delivery.9-14 In studies, ~4x more drug deposition was achieved with Aerogen during IMV,††9,10 non-invasive ventilation (NIV),‡‡11 and HF,12 and ~6x more drug deposition when SV‡‡13 versus  jet nebulisers.

Trusted

Globally renowned

Aerogen technology has been in use for over 25 years, in more than 75 countries globally and is associated with over 200 clinical papers and publications.15



COVID-19 Related Enquiries

COVID-19 Related Enquiries

The Aerogen team and our representatives are available globally, to answer your questions, provide an online demonstration, and place orders.

How can we help?

Guidelines

Clinical and scientific societies around the world recommend the use of closed-circuit nebulisers for the management of patients with COVID-19 requiring aerosol drug delivery:

  • GOLD: Science Committee Report 20231
  • AARC: Guidance 202016
  • ISAM: Interim Guidance 20208
  • Spanish Scientific Societies: Expert Clinical Consensus 202017
  • Chinese Thoracic Society: Respiratory Care Committee 202018
  • Indian Society of Critical Care Medicine: Position Statement 202019
  • Indian Chest Society: Guidance 202020

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†Studies by Joyce et al and McGrath et al were performed in in-vitro models of mechanical ventilation and self-ventilation, respectively; studies by Harnois et al and Li et al were self-ventilation and high-flow studies, respectively, performed in healthy subjects

‡Defined as median (interquartile range)  particulate number concentration during simulated drug refill in an in vitro model of invasive mechanical ventilation; between-group difference, 0/cm–3 (0.1–1.6) vs 710/cm-3 (265–1211); P=0.032

§Defined as fugitive aerosol concentrations versus baseline with Aerogen via Airvo 2 (high-flow) versus jet nebuliser with mouthpiece of facemask at particles of 1.0–3.0 µm (all P<0.05); study performed in healthy subjects.

Defined as fugitive aerosol concentrations with jet nebuliser vs Aerogen with a mask at particle sizes of 1.0–5 μm and with a mouthpiece at particle sizes of 0.5–3 μm (all P<0.05); study performed in healthy subjects

#Defined as mean aerosol concentrations at a distance of 0.8 m and 2.2 m over 30 minutes; in-vitro model of a self-ventilating adult

††When placed 15 cm from the Y-Piece in a heated setting; in-vitro model

‡‡Study performed in healthy subjects

  1. Global Initiative for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: 2023 report. Available at: https://goldcopd.org/2023-gold-report-2/ (accessed 06 December 2022).
  2. Joyce M, McGrath JA, Mac Giolla Eain M, et al. Nebuliser type influences both patient-derived bioaerosol emissions and ventilation parameters during mechanical ventilation. Pharmaceutics. 2021;13(2):199.
  3. 30-354 Rev U Aerogen Solo System Instruction Manual.
  4. McGrath JA, O’Sullivan A, Bennett G, et al. Investigation of the Quantity of Exhaled Aerosols Released into the Environment during Nebulisation. Pharmaceutics. 2019; 11(2):75.
  5. Harnois LJ, Alolaiwat AA, Jing G, et al. Efficacy of various mitigation devices in reducing fugitive emissions from nebulizers. Respir Care. 2022;67(4):394-403.
  6. Li J, Alolaiwat AA, Harnois LJ, Fink JB, Dhand R. Mitigating fugitive aerosols during aerosol delivery via high-flow nasal cannula devices. Respir Care. 2022;67(4):404-414.
  7. O'Toole C, Joyce M, McGrath JA, O'Sullivan A, Byrne MA, MacLoughlin R. Fugitive aerosols in the intensive care unit: a narrative review. Ann Transl Med. 2021;9(7):592.
  8. Fink JB, Ehrmann S, Li J, et al. Reducing aerosol-related risk of transmission in the era of COVID-19: An interim guidance endorsed by the International Society of Aerosols in Medicine. J Aerosol Med Pulm Drug Deliv. 2020;33(6):300-304.
  9. Ari A, Areabi H, Fink JB. Evaluation of aerosol generator devices at 3 locations in humidified and non-humidified circuits during adult mechanical ventilation. Respir Care. 2010;55(7):837-844.
  10. Ari A, Atalay OT, Harwood R, Sheard MM, Aljamhan EA, Fink JB. Influence of nebulizer type, position, and bias flow on aerosol drug delivery in simulated pediatric and adult lung models during mechanical ventilation. Respir Care. 2010;55(7):845-851.
  11. Galindo-Filho VC, Ramos ME, Rattes CS, et al. Radioaerosol pulmonary deposition using mesh and jet nebulizers during noninvasive ventilation in healthy subjects. Respir Care. 2015;60(9):1238-1246.
  12. Dugernier J, Hesse M, Jumetz T, et al. Aerosol delivery with two nebulizers through high-flow nasal cannula: a randomized cross-over single-photon emission computed tomography-computed tomography study. J Aerosol Med Pulm Drug Deliv. 2017;30(5):349-358.
  13. Dugernier J, Hesse M, Vanbever R, et al. SPECT-CT comparison of lung deposition using a system combining a vibrating-mesh nebulizer with a valved holding chamber and a conventional jet nebulizer: a randomized cross-over study. Pharm Res. 2017;34(2):290-30
  14. Berlinski A, Willis JR. Albuterol delivery by 4 different nebulizers placed in 4 different positions in a pediatric ventilator in vitro model. Respir Care. 2013;58(7):1124-1133.
  15. Aerogen Data on File
  16. American Association for Respiratory Care SARS CoV-2 Guidance Document. Available at https://www.aarc.org/wp-content/uploads/2020/03/guidance-document-SARS-COVID19.pdf (accessed 11 Nov 2022).
  17. Cinesi Gómez C, Peñuelas Rodríguez Ó, Luján Torné M, et al. Clinical consensus recommendations regarding non-invasive respiratory support in the adult patient with acute respiratory failure secondary to SARS-CoV-2 infection. Recomendaciones de consenso respecto al soporte respiratorio no invasivo en el paciente adulto con insuficiencia respiratoria aguda secundaria a infección por SARS-CoV-2. Med Intensiva (Engl Ed). 2020;44(7):429-438.
  18. Respiratory care committee of Chinese Thoracic Society. Zhonghua Jie He He Hu Xi Za Zhi. 2020;17(0):E020.
  19. Kumar S, Mehta S, Sarangdhar N, et al. Management of COVID-19 from the pulmonologist's perspective: a narrative review. Expert Rev Respir Med. 2021;15(4):519-535.
  20. Swarnakar R, Gupta NM, Halder I, et al. Guidance for nebulization during the COVID-19 pandemic. Lung India. 2021;38(Supplement):S86-S91.

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