Aerogen Ultra

Aerogen Ultraについて

吸入薬剤投与の世界的リーダー、Aerogen製Aerogen Ultra について†1

抜管後または増悪中に、手持ち式デバイスのAerogen UltraとAerogen Soloを併用し、吸入薬剤療法を行う方法2

75 か国を超える世界市場でビジネスを展開



  • 酸素ポートの使用により、オプションとして酸素の供給が可能2
  • チャンバー内のエアフローをコントロールし吸入薬剤送達を促進する、人間工学的バルブを備えたマウスピース2
  • 革新的なチャンバーデザインが実現する、薬剤投与最適化を目指した吸入薬剤リザーバー2
  • 細菌またはウイルスフィルターを容易に追加2できる拡張マウスピース

拡張マウスピース付きの Aerogen Ultra は、一部の地域のみで販売中です。入手の可否については、お住まいの地域を対象とした取扱説明書を参照してください。 

Aerogen Ultraの酸素投与用オプション

有効性

Aerogen Ultra は、自発呼吸中に有効薬剤投与をサポートします3-6

いくつかの研究により、Aerogen Ultra を用いた気管支拡張剤投与について、以下の結果が得られました。

  • ジェットネブライザーと比較し、自発呼吸中に肺送達される薬剤量が最大6倍3†
  • 他のネブライザーと比較して、大幅に少ないカップ内の残存薬剤量3,‡4

健常者を対象とした研究における群間差:34.1% vs 5.2%; p < 0.001
In-vitro/ex vivo モデル

患者ケア

Aerogen Ultraは、吸入薬剤に応じて、患者ケアを改善します5,6

ジェットネブライザーとの比較研究により、Aerogen Ultra を用いた気管支拡張薬投与について、以下の結果が得られました。

小児における中等度~重度の喘息増悪の場合:

  • 症状コントロールの達成に要した治療回数と時間が有意に減少†5
救急部門の患者を横断的に観察した結果:
  • 入院率が相対的に 32% 減少6
  • 患者の85%が、サルブタモール2.5mgの1回投与で症状コントロールを達成6
  • 救急部門滞在時間の中央値が 37 分短縮6

定義は、喘息増悪後に喘息スコアが軽度まで改善することとした

ワークフロー

ワークフローを簡素化するAerogen

  • 静音設計による薬剤投与のため、2 患者さんに常に静かな環境を提供
  • フローの追加不要2
  • Aerogen Soloは、汎用ネブライザー用に使用承認を得ている医療用吸入医薬品を、エアロゾル化するためのデバイスです。2
  • 1つのシステムでひとりの患者さんの呼吸療法全過程(IMV、NIV、HF、SV)、に対応し、継続的なケアを支援します。

構造

Aerogenの成功の核心は、独自のパラジウム製振動メッシュにあり、吸入薬剤の肺送達に理想的な粒子サイズを作り出します。 1,7

Aerogenのテクノロジーについて

Aerogen Ultra お問い合わせ

お問い合わせ

世界中から、AerogenチームとAerogen代理店にコンタクトが可能です。ご質問へのお答え、オンラインデモンストレーション、受注を担当いたします。

ご要望への対応

Aerogen Ultra

製品サポート

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 mask​26​. 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.  

セキュリティコードを入力してください:

  1. Aerogen Data on File. 
  2. 30-1487 Rev A Aerogen Ultra Instruction Manual.
  3. Dugernier J, Hesse M, Vanbever R, et al. Pharm Res. 2017;34(2):290-30.
  4. Lin H-L, Fang T–P, Cho H-S, et al. Pulm Pharmacol Ther. 2018;48:225-231.
  5. Moody GB, Luckett PM, Shockley CM, et al. Respir Care 2020;65(10):1451–1463.
  6. Dunne RB, Shortt S. Am J Emerg Med. 2018;36(4):641-646.
  7. 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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