PDF(Pubmed)
Abstract：
BACKGROUND: Reusable nebulizer-compressor combinations deliver inhaled medications for patients with chronic lung diseases. On hospital discharge, the patient may take home the disposable nebulizer that was packaged and combine it with their home compressor. Though this practice may reduce waste, it can increase variability in medication delivery. Our study compared several reusable and disposable nebulizers packaged with compressor kits used in the US. We included a common disposable hospital nebulizer that may not be supplied with popular home kits but may be brought home after a hospitalization or emergency department visit. We focused on fine droplet mass < 4.7 μm aerodynamic diameter (FDM<4.7 μm), associated with medication delivery to the airways of the lungs.
METHODS: We evaluated the following nebulizer-compressor combinations (n = 5 replicates): 1. OMBRA® Table Top Compressor with MC 300® reusable and Airlife™ MistyMax™ 10® disposable nebulizer, 2. Sami-the-Seal® compressor with SideStream® reusable and disposable nebulizers and Airlife™ MistyMax 10™ disposable nebulizer, 3. VIOS® compressor with LC Sprint® reusable, and VixOne® and Airlife™ MistyMax™ disposable nebulizers, 4. Innospire® Elegance® compressor with SideStream® reusable and disposable nebulizers and Airlife™ MistyMax 10™ disposable nebulizer, 5. Willis-the-Whale® compressor with SideStream® reusable and disposable nebulizers and Airlife™ MistyMax 10™ disposable nebulizer, 6. Pari PRONEB® Max compressor with LC Sprint® reusable and Airlife™ MistyMax 10™ disposable nebulizer. We placed a 3-ml albuterol solution (0.833 mg/ml) in each nebulizer. A bacterial/viral filter was attached to the nebulizer mouthpiece to capture emitted medication, with the filter exit coupled to a simulator of a tidal breathing adult (rate = 10 cycles/min; Vt = 600 ml; I/E ratio = 1:2). The filter was replaced at 1-min intervals until onset of sputter. Droplet size distributions (n = 5 replicates/system) were determined in parallel by laser diffractometry.
RESULTS: Cumulative FDM<4.7 μm varied from 381 ± 33 μg for the best performing combination (Proneb/LC-Sprint) to 150 ± 21 μg for the system with the lowest output (VIOS®/MistyMax 10™).
CONCLUSIONS: Substituting one nebulizer for another can result in large differences in medication delivery to the lungs.
METHODS: We evaluated the following nebulizer-compressor combinations (n = 5 replicates): 1. OMBRA® Table Top Compressor with MC 300® reusable and Airlife™ MistyMax™ 10® disposable nebulizer, 2. Sami-the-Seal® compressor with SideStream® reusable and disposable nebulizers and Airlife™ MistyMax 10™ disposable nebulizer, 3. VIOS® compressor with LC Sprint® reusable, and VixOne® and Airlife™ MistyMax™ disposable nebulizers, 4. Innospire® Elegance® compressor with SideStream® reusable and disposable nebulizers and Airlife™ MistyMax 10™ disposable nebulizer, 5. Willis-the-Whale® compressor with SideStream® reusable and disposable nebulizers and Airlife™ MistyMax 10™ disposable nebulizer, 6. Pari PRONEB® Max compressor with LC Sprint® reusable and Airlife™ MistyMax 10™ disposable nebulizer. We placed a 3-ml albuterol solution (0.833 mg/ml) in each nebulizer. A bacterial/viral filter was attached to the nebulizer mouthpiece to capture emitted medication, with the filter exit coupled to a simulator of a tidal breathing adult (rate = 10 cycles/min; Vt = 600 ml; I/E ratio = 1:2). The filter was replaced at 1-min intervals until onset of sputter. Droplet size distributions (n = 5 replicates/system) were determined in parallel by laser diffractometry.
RESULTS: Cumulative FDM<4.7 μm varied from 381 ± 33 μg for the best performing combination (Proneb/LC-Sprint) to 150 ± 21 μg for the system with the lowest output (VIOS®/MistyMax 10™).
CONCLUSIONS: Substituting one nebulizer for another can result in large differences in medication delivery to the lungs.
摘要：
背景：可重复使用的雾化器-压缩机组合为慢性肺部疾病患者提供吸入药物。出院时，患者可以将包装好的一次性雾化器带回家，并将其与家用压缩机结合起来。虽然这种做法可以减少浪费，它会增加药物输送的可变性。我们的研究比较了几种可重复使用和一次性的雾化器与美国使用的压缩机套件包装。我们包括一个普通的一次性医院雾化器，该雾化器可能不提供流行的家用套件，但可以在住院或急诊科就诊后带回家。我们专注于细液滴质量<4.7μm空气动力学直径（FDM<4.7μm），与药物输送到肺部气道有关。
方法：我们评估了以下雾化器-压缩机组合（n=5个重复）：1.OMBRA®台式压缩机，配有MC300®可重复使用和Airlife™MistyMax™10®一次性雾化器，2.Sami-the-Seal®压缩机，配有SideStream®可重复使用的一次性雾化器和Airlife™MistyMax10™一次性雾化器，3.带LCSprint®的VIOS®压缩机可重复使用，和VixOne®和Airlife™MistyMax™一次性雾化器，4.Innospire®Elegance®压缩机，配有SideStream®可重复使用的一次性雾化器和Airlife™MistyMax10™一次性雾化器，5.Willis-the-Whale®压缩机，配有SideStream®可重复使用的一次性雾化器和Airlife™MistyMax10™一次性雾化器，6.带有LCSprint®可重复使用和Airlife™MistyMax10™一次性雾化器的PariPRONEB®Max压缩机。我们在每个雾化器中放置3ml沙丁胺醇溶液（0.833mg/ml）。将细菌/病毒过滤器连接到雾化器口管以捕获发出的药物，过滤器出口耦合到潮式呼吸成人的模拟器（速率=10周期/分钟；Vt=600ml；I/E比=1：2）。以1分钟的间隔更换过滤器直到溅射开始。通过激光衍射法平行测定液滴尺寸分布(n=5次重复/系统)。
结果：累积FDM<4.7μm，从性能最佳的组合（Proneb/LC-Sprint）的381±33μg到输出最低的系统（VIOS®/MistyMax10™）的150±21μg不等。
结论：用一种雾化器代替另一种雾化器会导致肺部给药的差异很大。
方法：我们评估了以下雾化器-压缩机组合（n=5个重复）：1.OMBRA®台式压缩机，配有MC300®可重复使用和Airlife™MistyMax™10®一次性雾化器，2.Sami-the-Seal®压缩机，配有SideStream®可重复使用的一次性雾化器和Airlife™MistyMax10™一次性雾化器，3.带LCSprint®的VIOS®压缩机可重复使用，和VixOne®和Airlife™MistyMax™一次性雾化器，4.Innospire®Elegance®压缩机，配有SideStream®可重复使用的一次性雾化器和Airlife™MistyMax10™一次性雾化器，5.Willis-the-Whale®压缩机，配有SideStream®可重复使用的一次性雾化器和Airlife™MistyMax10™一次性雾化器，6.带有LCSprint®可重复使用和Airlife™MistyMax10™一次性雾化器的PariPRONEB®Max压缩机。我们在每个雾化器中放置3ml沙丁胺醇溶液（0.833mg/ml）。将细菌/病毒过滤器连接到雾化器口管以捕获发出的药物，过滤器出口耦合到潮式呼吸成人的模拟器（速率=10周期/分钟；Vt=600ml；I/E比=1：2）。以1分钟的间隔更换过滤器直到溅射开始。通过激光衍射法平行测定液滴尺寸分布(n=5次重复/系统)。
结果：累积FDM<4.7μm，从性能最佳的组合（Proneb/LC-Sprint）的381±33μg到输出最低的系统（VIOS®/MistyMax10™）的150±21μg不等。
结论：用一种雾化器代替另一种雾化器会导致肺部给药的差异很大。
