Help Centre: FAQs about Aerogen Solo

Aerogen Solo


What brands or models of ventilators can use the Aerogen Solo?

The Aerogen Solo can be used with any brand or model of ventilator. Aerogen technology is integrated in ventilators made by Hamilton Medical, Maquet, and GE Healthcare.




How long does it take to deliver a unit dose?

The flow rate of the Aerogen Solo is > 0.2ml/min with an average of 0.38ml/min. For a standard 3ml dose this would therefore take 7 minute 53 seconds13.




How much medication is left at the end of a treatment?

Medication left in the nebuliser at the end of the treatment is minimal: < 0.1mL13.




How much medication can be given at one time?

The medication cup can hold up to 6mL of medication.




Can the Aerogen Solo be used with a mouthpiece and an aerosol mask?

Yes, the Aerogen Solo can be connected to the Aerogen Ultra and used with a mouthpiece or aerosol mask.




How quiet is the Aerogen Solo?

The Aerogen Solo is virtually silent. The noise level is less than 35dB measured at 0.3m distance.




How do I clean the Aerogen Solo?

The Aerogen Solo is a single patient use device and can be used for up to 28 days inline on a ventilator circuit based on a typical usage of 4 intermittent treatments per day. For continuous use, the Aerogen Solo is qualified for a maximum of 7 days. Nebulising a few drops of normal saline can remove any drug residue between doses (which can occur occasionally with viscous drugs). The Aerogen Solo should not be removed from the patient circuit for cleaning.




How do you remove residue in the chamber after nebulisation of viscous drugs?

In order to remove any residue of viscous drugs, you can nebulise a few drops of normal saline.




What medications can the Aerogen Solo deliver?

The Aerogen Solo can nebulise physician-prescribed medications for inhalation which are approved for use with a general purpose nebuliser. For more information on specific drugs and dosages please contact our Clinical team: medicalscience@aerogen.com (US)/ msl@aerogen.com (Rest of world).




Can we use multiple types of drug in the same Aerogen Solo?

You don’t need a different Aerogen Solo to nebulise different drugs, but when nebulising viscous drugs you may need to add a few drops of saline to clear the mesh before nebulising the next drug. Always refer to the drug manufacturer’s guidelines before combining drugs for nebulisation.




How long can you use the Aerogen Solo?

The Aerogen Solo is a single patient use device and can be used for 28 days based on a typical usage of 4 intermittent treatments per day. For continuous use, the Aerogen Solo is qualified for a maximum of 7 days.




How does the lung deposition of drugs with the Aerogen Solo compare to standard nebulisers?

The Aerogen Solo provides 10-15% lung deposition compared to standard jet nebuliser (3%) during mechanical ventilation15, 16. Nearly four times more is delivered with Aerogen during NIV17. Also, using the Aerogen Ultra, spontaneously breathing subjects showed six times greater deposition compared to jet nebulisers18.




What should I do if the Aerogen Solo stops nebulising?

Please refer to the trouble shooting guide in the directions for use.




How do I get replacement parts?

Contact your local Aerogen Solo Distributor. (Refer to https://www.aerogen.com/distributors/)




What should I do if the expiratory filter becomes saturated causing the ventilator to alarm following nebulisation?

This can happen on rare occasions. If the Aerogen Solo is positioned near the wye then moving it back to the humidifier will result in less aerosol reaching the expiratory filter (which may resolve the problem) and more drug being delivered to the patient. Occluded filters should be replaced with a new filter and changed according to manufacturer recommendations and as needed.




Can Aerogen be sent home with patients?

The Aerogen Solo can be used at home for patients requiring any type of ventilator support using the Aerogen USB controller. For spontaneous breathing patients, the InnoSpire Go is available from Philips and utilises the same Aerogen vibrating mesh technology.




Can the Aerogen Solo be used during Non-Invasive Ventilation?

Placement of the Aerogen Solo during non-invasive ventilation (BIPAP/CPAP) is improved when the nebuliser is placed between the fixed leak in the circuit and the patient. A bench study by Abdelrahim et al. (2010) demonstrated that aerosol delivery is higher between the leak and the mask. The Aerogen device delivered twice as much aerosol as compared to a standard jet nebuliser 18.

When using non-invasive ventilation with a critical care ventilator (dual limb) you can position the nebuliser on the dry side of the humidifier, at the wye- piece or at the mask. Velasco et al. (2018) reported in a pediatric model that the aerosol dose was significantly higher if the Aerogen Solo was placed at the wye or mask however acceptable levels were still noted at the dry side of the humidifier19.




Does the use of the Aerogen Solo increase condensation within the circuit?

Rain-out in the circuit due to aerosol delivery via the Aerogen Solo should be minimal. Placement back on the dry (ventilator) side of the humidifier may reduce rain-out because the large aerosol particles could rain-out in the humidifier chamber versus in the circuit. The amount of aerosol delivery over time will affect the amount of rain-out produced.




Does the position of the Aerogen Solo depend on the weight of the patient or the flow rate?

No. The placement of the Aerogen Solo and the T-piece is a matter of choice for the healthcare provider, however, it is important to note that the placement of the T-piece between the wye ant the ET tube will increase the dead space volume. It will also add to increased weight of the circuit.




Can the Aerogen Solo be used with neonatal ventilators containing proximal flow sensors?

Please refer to the Ventilator Instructions for Use.

Please note that Aerogen products are not approved for use with neonates within the USA.




Will the nebuliser affect the expiratory flow sensor/filter?

Any aerosol added to a ventilator circuit could potentially affect the expiratory flow sensor and expiratory filter as moisture in the circuit is increased. Expiratory Flow flow sensors can be adversely affected especially in certain ventilators. More aerosol in the circuit can cause the expiratory ventilator filters to become saturated more quickly and increase the resistance to exhalation. Filters should be monitored as well as patient expiratory resistance. Changing the filters may be required on a regular basis. Please consult the relevant Ventilator Manufacturers (IFU) Instructions for Use Manuals, for filter specific requirements.

An expiratory filter should always be in line to protect the internal mechanisms in the ventilator and change the expiratory filter as needed. Viscous medications may require more frequent filter changes. Please consult the relevant Ventilator Manufacturer’s (IFU) Instructions for Use Manuals, for filter specific requirements.




Where do you place the Aerogen Solo with neonate patients?

Although the research does show that there is better aerosol delivery closer to the patient in a neonatal circuit, it is also important to note that there is still adequate aerosol delivery associated with the Aerogen Solo at the ventilator. Berlinski et al. (2016) demonstrated between 8.2 and 9.5% deposition with the Aerogen Solo placed back at the ventilator in a neonatal mechanical ventilation model22. This should be more than enough to be clinically significant in an infant.

Clinicians may prefer to place the nebuliser on the dry side of the humidifier for a variety of reasons including less rainout at the wye, less aerosol on the flow sensor and it may eliminate the problem of added weight which could result in accidental extubation.



References

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Albuterol delivery by 4 different nebulisers placed in 4 different positions in a paediatric ventilator in vitro model. Respir Care 2013; 58: 1124–1133. 7. Ari A, Fink JB. Aerosol Drug Delivery During Mechanical Ventilation: Devices, Selection, Delivery Technique, and Evaluation of Clinical Response to Therapy. Clin Pulm Med 2015; 22: 79–86. 8. Reminiac F, Vecellio L, Loughlin RM, Le Pennec D, Cabrera M, Vourc’h NH et al. Nasal high flow nebulisation in infants and toddlers: An in vitro and in vivo scintigraphic study. Pediatr Pulmonol 2017; 52: 337–344. 9. Li J, Gong L, Ari A, Fink JB. Decrease the flow setting to improve trans‐nasal pulmonary aerosol delivery via “high‐flow nasal cannula” to infants and toddlers. Pediatr Pulmonol 2019; : ppul.24274. 10. Aerogen Solo System Instruction Manual. Aerogen Ltd. P/N 30-354, Part No. AG-AS3050.  11. Alcoforado L, Ari A, De Melo Barcelar J, Brandao SS, Fink JB, Dornelas De Andrade A. Comparison of Aerosol Deposition with Heated and Unheated High Flow Nasal Cannula (HFNC) in Healthy Adults. Poster Present ATS 2016. 12. Reminiac F, Vecellio L, Bodet-Contentin L, Gissot V, Le Pennec D, Salmon Gandonniere C et al. Nasal high-flow bronchodilator nebulisation: a randomized cross-over study. Ann Intensive Care 2018; 8: 128. 13. Dhand R. Basic techniques for aerosol delivery during mechanical ventilation. Respir Care 2004; 49: 611– 22. 14. Berlinski A, Willis JR. Effect of Tidal Volume and Nebuliser Type and Position on Albuterol Delivery in a Paediatric Model of Mechanical Ventilation. Respir Care 2015; 60: 1424–1430. 15. Dugernier J, Reychler G, Wittebole X, Roeseler J, Depoortere V, Sottiaux T et al. Aerosol delivery with two ventilation modes during mechanical ventilation: a randomized study. Ann Intensive Care 2016; 6: 73. 16. MacIntyre NR, Silver RM, Miller CW, Schuler F, Coleman RE. Aerosol delivery in intubated, mechanically ventilated patients. Crit Care Med 1985; 13: 81–84. 17. Galindo-Filho VC, Ramos ME, Rattes CS, Barbosa AK, Brandao DC, Brandao SCS et al. Radioaerosol Pulmonary Deposition Using Mesh and Jet Nebulisers During Noninvasive Ventilation in Healthy Subjects. Respir Care 2015; 60: 1238–1246. 18. Dugernier J, Hesse M, Vanbever R, Depoortere V, Roeseler J, Michotte JB et al. SPECT-CT Comparison of Lung Deposition using a System combining a Vibrating-mesh Nebuliser with a Valved Holding Chamber and a Conventional Jet Nebuliser: a Randomized Cross-over Study. Pharm Res 2017; 34: 290–300. 19. Abdelrahim ME, Plant P, Chrystyn H. In-vitro characterisation of the nebulised dose during non-invasive ventilation. J Pharm Pharmacol 2010; 62: 966–972. 20. Berlinski A, Velasco J. Albuterol Delivery Efficiency in a Paediatric Model of Noninvasive Ventilation With a Single-Limb Circuit. Respir Care 2019; : respcare.06622. 21. Velasco J, Berlinski A. Albuterol Delivery Efficiency in a Paediatric Model of Noninvasive Ventilation With Double-limb Circuit. Respir Care 2018; 63: 141–146. 22. Berlinski A, Kumaran S. Particle Size Characterization of Nebulised Albuterol Delivered by a Vibrating Mesh Nebuliser Through Paediatric Endotracheal Tubes. POster Present ATS 2016. 23. Dubus JC, Vecellio L, De Monte M, Fink JB, Grimbert D, Montharu J et al. Aerosol deposition in neonatal ventilation. Pediatr Res 2005; 58: 10–14. 24. Ní Mhurchú Sorcha, Brady Paul, McKenna Cathy, Bennett Gavin , Joyce Mary, Sweeney Louise MR. Effect of Nebuliser Position on Aerosol Delivery during Mechanical Ventilation of a Neonate. Irish Thorac Soc poster 2018. 25. Ari A, Fink JB, de Andrade AD, AlHamad B, Sheard M, AlHamad B et al. Performance Comparisons of Jet and Mesh Nebulisers Using Different Interfaces in Simulated Spontaneously Breathing Adults and Children. J Aerosol Med Pulm Drug Deliv 2015; 28: 281–289. 26. Ari A, Pt R, Faarc C, Restrepo RD, Faarc R. AARC Clinical Practice Guideline Aerosol Delivery Device Selection for Spontaneously Breathing Patients: 2012. 2012. doi:10.4187/respcare.01756. 27. Aerogen Pro System Instruction Manual. Aerogen Ltd. Part No. AG-AP1080 P/N 30-040. Aerogen Ltd.

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