Drug Concentrations in the Air and their Influencing Factors in a Pediatric Intensive Care Unit

Aerosolized drug therapy is a common approach in treating respiratory diseases in clinical practice. This study aimed to assess air quality in the pediatric intensive care unit (PICU) of the medical center and investigate variations in drug concentration relative to the patient’s position during aerosolized drug treatment. To monitor air quality and aerosolized drug concentrations in the PICU, we conducted bi-weekly 24-hour samplings over a month. Monitored air quality parameters included temperature, relative humidity (RH), carbon dioxide (CO2), particulate matter (PM), total volatile organic compounds (TVOCs), and aerosolized drug levels in the air. The study also used a small volume nebulizer (SVN) to analyze the relationship between aerosolized drug concentration and distance from a simulated patient. This study revealed that the average concentrations of CO2, PM10 (an aerodynamic diameter equal to or less than 10 µm), and PM2.5 (an aerodynamic diameter less than 2.5 µm) in the PICU met Taiwan’s Ministry of Environment (MOENV) indoor air quality standards. However, the hourly average concentration of TVOCs in the PICU was almost twice the MOENV standard. The concentration of acetylcysteine in the air showed a positive association with both RH and CO2 concentration. Additionally, drug concentrations measured at 1 m, 1.6 m, and 3 m from the SVN were significantly lower than those measured at 0.1 m from the SVN. Continuous monitoring of TVOCs and CO2 in the PICU is necessary. During aerosol therapy, it is crucial for medical staff and family members to maintain a safe distance or integrate a HEPA (high-efficiency particulate air) filter into the ventilator circuit system. This precautionary step aims to minimize unwarranted exposure and maintain hospital air quality.