Volume 3 Supplement 1

EAACI International Severe Asthma Forum (ISAF 2012): Abstracts

Open Access

Is the measurement of delivered dose a good performance measure? A characterization of delivered and respirable delivered dose in two brands of jet nebulizer

  • Mariam Rehman1,
  • Adam Metcalf1 and
  • Ross Hatley1
Clinical and Translational Allergy20133(Suppl 1):P10

https://doi.org/10.1186/2045-7022-3-S1-P10

Published: 3 May 2013

Background

Use of a nebulizer facilitates rapid administration of high doses of drug, which is desirable for patients presenting with acute severe asthma. Breath-enhanced jet nebulizers direct the patient s air flow through the nebulizer handset during inhalation producing aerosol output with a more favorable respirable profile. SideStream Plus (SS+; Philips Respironics) and Nebutech (NB; Salter Labs) are breath-enhanced jet nebulizers, designed to produce a high delivered dose in a short treatment time. A previous in vitro characterization of delivered dose and droplet size distribution of arformoterol nebulized via the SS+ and the NB indicated that the SS+ performed favorably, compared with the NB.[1] We present results of an in vitro characterization of salbutamol sulphate (albuterol sulfate) delivery via the SS+ nebulizer and the NB nebulizer.

Method

Each nebulizer was filled with 3 ml salbutamol sulphate (5 mg/2.5 ml) and run with a driving flow of 8 l/min into a CEN adult tidal breathing pattern (Vt; 500 ml, 15 BPM, I:E ratio; 1:1). The nebulizers were run in triplicate to sputter point and sputter point plus 60 s. Dose delivered to a filter (delivered dose; DD), placed between the nebulizer and breathing emulator, was quantified using high performance liquid chromatography and expressed as a µl solution equivalent. A laser diffractor (Malvern Spraytec) was used to assess fine particle fraction (FPF) and mass median diameter (MMD) after 60 s nebulization time. Fine particle dose (FPD) was calculated (FPF x delivered dose).

Results

The results are shown in Table 1

Table 1

Experimental parameter

SS+

NB

MMD (µm)

3.2

5.6

FPF (%<5 µm)

74.2

43.7

DD; Sputter (µl solution)

432

424

FPD; Sputter (µl solution)

321

185

DD; Sputter + 60 s (µl solution)

542

594

FPD; Sputter + 60 s (µl solution)

402

260

Conclusion

The total DD from the 2 nebulizers was comparable. Aerosol delivered via the SS+ nebulizer had a lower MMD and higher FPF, compared with that delivered via the NB nebulizer. This resulted in a 74% higher FPD delivered to sputter, and a 55% higher FPD delivered to sputter plus 60 s from the SS+ nebulizer compared with the NB nebulizer. The FPD represents respirable aerosol, and is therefore more clinically relevant than the DD. These results are consistent with previous work, and indicate that a high respirable dose of aerosol is produced by the SS+ nebulizer [1].

Authors’ Affiliations

(1)
Respironics Respiratory Drug Delivery (UK) Ltd, Philips Home Healthcare Solutions

References

  1. Bauer A: Respir Care. 2009, 54 (10): 1342-1347.PubMedGoogle Scholar

Copyright

© Rehman et al; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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