Descubra o Aerogen Ultra – líder global em entrega de medicamento em aerossol†1
Descubra como o Aerogen Ultra – um dispositivo portátil – pode ser usado em conjunto com o Aerogen Solo para administrar tratamento por inalação durante exacerbações ou na pós-ventilação.2
†Presença de mercado global em mais de 75 países
- A entrada de oxigênio permite entrega opcional de oxigênio2
- Uma peça bucal ergonômica com válvula que controla o fluxo de ar pela câmera para otimizar a entrega de medicamento em aerossol2
- O projeto de câmara inovador oferece um reservatório de aerossol que otimiza a entrega de medicamento2
- Peça bucal estendida‡ para facilitar o encaixe de um filtro bacteriano ou viral2
‡O Aerogen Ultra com bocal estendido está disponível apenas em regiões selecionadas. Consulte o manual de instruções relevante da sua região para
Eficácia
Facilita a entrega eficaz do medicamento durante a respiração espontânea3–6
Em estudos, a administração de broncodilatadores por meio do Aerogen Ultra foi associada a:
- Entrega de 6 vezes mais medicamento aos pulmões durante a respiração espontânea em relação a um nebulizador a jato3†
- Significativamente menos sobra de medicamento no copo em relação a outros nebulizadores3,‡4
†Estudo realizado em indivíduos saudáveis; diferença entre grupos: 34,1% versus 5,2%; p<0,001.
‡Modelos in-vitro/ex vivo
Tratamento do paciente
O Aerogen Ultra melhora o tratamento do paciente em resposta ao medicamento aerossolizado5,6
Em estudos, quando comparado a nebulizadores a jato, a administração de broncodilatadores por meio do Aerogen Ultra foi associada a:
Em crianças com exacerbação de asma moderada a grave:
- Consideravelmente menos tratamentos e menos tempo necessário para alcançar o controle dos sintomas†5
- Redução relativa de cerca de 32% nas taxas de admissão hospitalar6
- 85% dos pacientes obtiveram controle dos sintomas com uma única dose de salbutamol de 2,5 mg6
- Redução de 37 minutos na duração mediana da permanência no pronto-socorro6
†Definido como a obtenção de uma pontuação leve de asma após uma exacerbação da asma
Fluxo de trabalho
O Aerogen simplifica o fluxo de trabalho
- Entrega de medicamento praticamente inaudível2, mantendo um ambiente tranquilo para os pacientes
- Sem fluxo adicional2
- O Aerogen está aprovado para aerossolização de medicamentos para inalação prescritos pelo médico aprovados para utilização com um nebulizador de fins gerais2
- Um sistema usado durante toda a jornada respiratória do paciente (VMI, VNI, CNAF, RE),2 dando suporte à continuidade dos cuidados
Como funciona
O segredo do sucesso do Aerogen é sua exclusiva malha vibratória de paládio que cria o tamanho ideal de partícula para entregar o medicamento inalado aos pulmões.1,7
Consultas
A equipe da Aerogen e nossos representantes estão disponíveis em todo o mundo para responder às suas perguntas, fornecer uma demonstração online e processar o seu pedido.
Aerogen Ultra
Suporte ao produto
Aerogen Ultra with a face mask for EMS use: set-up guide
Aerogen Ultra with mouthpiece for EMS use: set-up guide
Aerogen Solo on a NIV single-limb circuit for EMS use: set-up guide
Aerogen Solo on the dry side of the humidifier: set-up guide
Aerogen Solo for adult nasal high-flow: set-up guide
Aerogen Solo for paediatric nasal high-flow: set-up guide
Aerogen Solo at the wye: set-up guide
Aerogen Continuous Nebulisation Tube: set-up guide
Aerogen Ultra: set-up guide
Aerogen Solo at the wye for EMS use: set-up guide
Aerogen Solo for adult high-flow for EMS use: set-up guide
Aerogen Solo on the dry side of the humidifier for EMS use: set-up guide
General
I have a medical/clinical query, or my query is not addressed below. Who can I contact for medical or clinical information related to the use of Aerogen products?
Please contact Aerogen Medical Affairs directly for medical information/published clinical research regarding the use of Aerogen products. Email: MedicalScience@aerogen.com (US/Canada/LATAM) or msl@aerogen.com (all other countries).
What medications can be used with the Aerogen Solo, Aerogen Pro?
The Aerogen Solo & Aerogen Pro should be used with physician prescribed medications for inhalation which are approved for use with a general purpose nebuliser.¹ Should you require information on a whether a medication is approved for inhalation please contact the medication manufacturer directly.
Should I adjust the drug dosage when I’m using the Aerogen Solo, Aerogen Pro?
Information on drug dosing must be sourced from the manufacturer’s approved prescribing information for the inhaled formulation. Aerogen Ltd cannot provide specific advice on medication dose.
Is the drug affected if it causes discoloration of the water in a humidifier?
Occasionally, a change in the colour of the water in a heated humidifier has been noted with certain medications if aerosolized proximal to the humidifier. Should you have concerns related to a specific medication please do not hesitate to contact the Medical Affairs team at the email addresses listed above for assistance. The treating clinician should always consider a medications SPC and/or consult with a pharmacist/hospital pharmacy to determine whether placement proximal to the humidifier is suitable for a given therapeutic. Aerogen devices are approved for use in a number of positions offering the treating health care professional a range of placement options if discoloration is a concern. These positions are detailed in the directions for use documents which are accessible on the website.¹
What do I do if crystals form in the nebuliser chamber?
Any medication that has a high ionic concentration, for instance hypertonic saline solutions, if permitted to dry on the Aerogen Vibronic aerosol generator in the nebuliser chamber, may form visible crystals. In the event where crystallisation is observed in the Aerogen Solo, Aerogen recommend to aerosolise a few drops of normal saline solution to clear any residual crystallisation.
How do you remove residue in the chamber after nebulisation of viscous drugs?
Should you wish to remove any viscous drug residues from the Aerogen Solo medication reservoir you may nebulise a few drops of normal saline.
What effect does bias ventilator flow have on aerosol output and deposition?
The impact of bias ventilator flow on aerosol deposition depends on the location of the aerosol generator in the circuit. An in vitro study by Ari et al., (2010) assessing aerosol delivery during mechanical ventilation in the presence of bias flow determined that optimal aerosol deposition may be achieved by nebuliser placement on the dry side of humidifier. Similarly, Berlinski & Willis (2013) demonstrated in a paediatric model, that in the presence of bias flow, nebulisers were more effective when placed back at the humidifier as compared to closer to the wye.²⁻³ In the absence of bias flow optimal deposition was observed when the nebuliser was placed at or close to the wye in this adult model.⁴
Can you use a Heat and Moisture Exchange Device (with filter) (HME/HMEF) while delivering aerosol with the Aerogen Solo?
Yes, the Aerogen Solo is approved for use with a HME.¹ The Aerogen Solo should be placed between the patient and HME as detailed in the Aerogen Solo directions for use.¹ Note: Only a HME/HMEf approved for use with a nebuliser should be used. Follow the HME/HMEf manufacturer instructions regarding use with a nebuliser. Ensure the combination of nebuliser, T-piece and HME/HMEf volumes are suitable for the tidal volume being delivered, according to the patient size.
What are the advantages of Aerogen vibrating mesh nebulisers (VMN) compared with other nebulisers, or inhalers for adult and pediatric patients?
Aerogen vibrating mesh nebulisers are electrically powered, quiet and require no additional flow or pressure to operate, ensure a minimal residual volume and are suitable for use with physician prescribed solutions that are approved for use with a general-purpose nebulisers.¹ A narrative review by Lin et al. compared VMN with other, similar, during invasive mechanical ventilation.⁵
Can you deliver an effective dose with the Aerogen Solo to an adult patient during High flow therapy?
Both in vitro and in vivo studies have examined aerosol delivery efficiency via Aerogen devices concurrent with High Flow Nasal Oxygen therapy with adult models/patients⁶⁻¹⁰ These studies suggest that an effective dose may be delivered during concurrent High Flow Nasal Oxygen therapy and medication aerosolisation via the Aerogen Solo.⁶⁻¹⁰
Do different ventilator parameters affect aerosol delivery?
Yes, a range of ventilator parameters; including flow, inspiratory time (duty cycle), ventilatory mode, timing of nebulisation and circuit features; tube sizes, heat, and humidification, can affect aerosol delivery in mechanically ventilated patients.2,11-13 Reviews by Dr. Dhanani and others summarise the impact of these features on aerosol delivery.11,13
Aerogen Ultra
What type of masks can be used with the Aerogen Solo with Aerogen Ultra accessory?
The Aerogen Solo with Aerogen Ultra accessory is supplied with a valved mask*. Other standard aerosol masks may also be connected. When using an aerosol face mask, a minimum oxygen flow of 1 LPM is required. Flow rate should be set between 1-6 LPM.1 For the US market, a max flow rate of 2 LPM should be set for paediatric patients.25 Never use a closed face mask with the Aerogen Ultra. In an in vitro study Ari et al. reported drug delivery via the Aerogen Solo with Aerogen Ultra and a valved mask was greater than with an open mask.26 *Adult or Paediatric masks not available in all markets.
Can a filter be used with the Aerogen Solo with Aerogen Ultra accessory to reduce emissions?
The Aerogen Ultra extended mouthpiece has a 22mm(F) ISO 5356-1 connection port to facilitate the attachment of an ISO 5356-1 compliant filter port1. The extended mouthpiece is approved in most, but not all, countries. Please contact your local representative to confirm if it is available in your region. If using the extended mouthpiece, when selecting a filter for the attachment of the Aerogen Ultra mouthpiece, Aerogen recommend using a filter with a minimum efficiency rating of 99.9% (Bacterial) or 99.8% (Viral)1. It is the responsibility of the clinician to determine if a filter is required and the type of filter selected for use (Viral/Bacterial) in conjunction with the Aerogen Ultra accessory.
How do I clean the Aerogen Ultra accessory?
The Aerogen Ultra accessory is approved for single patient use and is not intended to be cleaned1. After the life of the Ultra has been reached (see below) it should be disposed of appropriately. Excess rainout or residue may be removed should you wish by rinsing through with sterile water, shaking off any excess and allowing the Aerogen Ultra to air dry.
How long can I use the Aerogen Solo with Aerogen Ultra accessory?
The Aerogen Ultra accessory when used with the Aerogen Solo nebuliser is qualified for 20 intermittent (30-minute mode) use treatments (at a rate of four doses per day over 5 days) or 3 hours of continuous use with a single patient.¹
What medications can the Aerogen Solo with Aerogen Ultra accessory deliver?
The Aerogen Solo with Aerogen Ultra accessory can nebulise physician-prescribed medications for inhalation which are approved for use with a general- purpose nebuliser. Please consult the medication manufacturer for information on whether a specific therapeutic agent is approved for inhalation. Please contact Aerogen Medical Affairs directly for medical information/published clinical research regarding the use of Aerogen products please email: MedicalScience@aerogen.com (US/Canada/LATAM) or msl@aerogen.com (all other countries).
Should I adjust the drug dosage when using the Aerogen Solo with Aerogen Ultra?
Information on drug dosing must be sourced from the manufacturer’s approved prescribing information for the inhaled formulation. Aerogen Ltd cannot provide specific advice on medication dose. Please contact Aerogen Medical Affairs directly for medical information/published clinical research regarding the use of Aerogen products. Email: MedicalScience@aerogen.com (US/Canada/LATAM) or msl@aerogen.com (all other countries).
How does the lung deposition of drugs with the Aerogen Solo with Aerogen Ultra compare to standard nebulisers?
In independent clinical studies undertaken by Dugernier and colleagues, & Alcoforado et al., pulmonary aerosol deposition was up to six times greater with the Aerogen Solo with Aerogen Ultra accessory as compared to standard nebulisers.16,18
What is the best type of mask to use with the Aerogen Solo with Ultra?
In an in vitro study Ari et al. reported drug delivery via the Aerogen Solo with Ultra and a valved mask was greater than with an open mask26. In this study Ari and colleagues suggested that the greatest aerosol dose with the Aerogen Solo with Ultra may be obtained with the mouthpiece and no supplementary flow.26
Should I use the mouthpiece or mask with paediatric patients?
The health care professional, clinician or caregiver is best placed to make a clinical judgement in all cases as to the best interface for a given patient and whether a patient can effectively cooperate and hold a mouthpiece in their lips. The American Association Respiratory Care Clinical Practice Guidelines on aerosol delivery recommend use of a mouthpiece with patients ≥ 3 years old.27,28 If it has been determined that a patient cannot use a mouthpiece effectively then a mask should be used. Ensure the mask fits securely on the face of the patient and a good seal is achieved.
- Aerogen Data on File.
- 30-1487 Rev A Aerogen Ultra Instruction Manual.
- Dugernier J, Hesse M, Vanbever R, et al. Pharm Res. 2017;34(2):290-30.
- Lin H-L, Fang T–P, Cho H-S, et al. Pulm Pharmacol Ther. 2018;48:225-231.
- Moody GB, Luckett PM, Shockley CM, et al. Respir Care 2020;65(10):1451–1463.
- Dunne RB, Shortt S. Am J Emerg Med. 2018;36(4):641-646.
- Labiris NR, Dolovich MB. Pulmonary drug delivery. Part I: physiological factors affecting therapeutic effectiveness of aerosolized medications. Br J Clin Pharmacol. 2003;56(6):588-599.
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