VMN (vibrating mesh nebulization). History Irish company, founded in Galway, started in 1997 CEO John Power 2015- AARC Zenith Award- 3 million patient world wide

1. AEROGEN – The art of nebulization
VA Palo Alto Hospital

2. What is aerogen?
• High efficiency
vibrating mesh
aerosol drug
delivery system
• Inline or stand
alone
Aerogen is the company

3. When do we use it
here at theVA?
• Unit dose medication –
1. Mech.Ventilator (in-line)
2. V60
• Continuous aerosol - Flolan
• Transport – ambu bag

4. How does it benefits us?
• Contamination Risk
• Drug deposition- high quality
• No additional flow to system – does not trigger vent alarms
• Cost Reduction – monthly
• 22% Decrease in LOS in ICU
• Improve staff satisfaction
• All medications (including abx, mucomyst)
Note: rinse with couple of drops of NaCl- clears the pores

5. Comparison of Aerogen to MDI
Economical drug delivery,
savings verses MDI
Easy to operate
Propellant free
Delivers more drug per
dose
•High cost per canister
•Technique dependent –
timed with inspiration
•HFA propellants
•Delivers less drug per dose
Aerogen MDI

6. comparison of Aerogen to standard nebs
9 times more drug deposition
than SVN
No flow added to the circuit
Reduction in time to deliver
meds – 7.5mg continuous neb
cut from 1-hour to 8-minutes
Faster patient response
Drug waste – residual volume
0.8 -1.2ml
Adds flow requiring changes in
vent parameters
Re nebulizes condensate
Contamination risks
Aerogen Standard nebulizer

7. Efficiency Studies

8. Set Up
• V500
• LTV
Drager XL is retiring!!
Filter! Filter!

10. Set up on NIV
(Mask)
V60
Position #2
Not here!

11. Aerogen-V60 Set up on patient

12. Flolan set up
-Before-

13. Flolan Set up
-after-
Dual Pump or syringe?

14. Trouble shooting
R
I
G
H
T
W
R
O
N
G
Check:
•Connections
•Power Source
•Position
1.Adaptor
2.Aerogen

15. Transport
During Flolan transport

16. Future:
Continuous Neb in ED and HFNC

17. Why in ED?

18. Policy and procedure
• Please see VA policy procedure manual book.
• Respiratory Department
• Also check out Aerogen handbook for more detailed
information!

19. How to use it?
(Set up)
DEMO TIME!

20. The END
1.) Clinical White Paper document “Aerogen, Pioneering Aerosol Drug Delivery”, Retrieved
(2016, October 31) from www.aerogen.com Dangan, Galway Ireland, Aerogen Ltd.
2.) Power Point presentation “The Art of Nebulization” by: Peter Kahane CRT, RCP, AE-C,
Retrieved (2016, October 30)
3.) PubMed Article, from Nih.gov “Performance Comparisons of Jet and Mesh Nebulizers Using Different
Interfaces in Simulated Spontaneously Breathing Adults and Children”, retrived (2016, October 31) from
https://www.ncbi.nlm.nih.gov/pubmed/25493535
Questions?
References:
Special thanks to: Byron Shipp for the policy and procedures.