Assessment of Antibiotic Aerosol Generation Using Commercial Jet Nebulizers

Hurley, Paul K.; Smye, S W; Cunliffe, Helen

doi:10.1089/jam.1994.7.217

Cited by 19 publications

(11 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is not the first study to illustrate the in vitro differences in nebulizer performance, but it is unique in demonstrating the impact of the V D on the efficiency of a device with regards to total nebulized drug output when the effect of evaporative losses are taken into consideration. The RF observed for the four devices is within the range reported in previous studies (14,15,19,29). Hess et al (6) reported V D data, unfortunately nebulizer specific comparisons were not possible because the data in this study were pooled for all nebulizer types for different flow and volume settings.…”

supporting

confidence: 79%

“…For the purpose of this investigation, as in keeping with other studies (1,6,18,19), 30 s without aerosol production was identified as end nebulization. In the trials using the Updraft II, the generation of intermittent aerosol was limited, and, thus, it was easy to assess this endpoint.…”

Section: Figure 2) Mean Respirable Fraction Within a 95% CI At Flows mentioning

confidence: 89%

“…As outlined above, the total fill volume of each nebulizer was 4 mL (3) based on a unit density of 1 g/mL, prenebulization weight minus dry nebulizer weight equaled 4 g). End nebulization was defined as the period of 30 consecutive seconds when no aerosol was generated (1,6,18,19). V D was determined by subtracting the dry nebulizer weight from the postnebulization weight.…”

Section: Methodsmentioning

confidence: 99%

“…If the differences in the nebulizing flow are considered, the particle size distributions observed were in keeping with other studies (14,28). While the calculation of expected D E was based upon specific assumptions, these assumptions were the same for each device so, even if not absolutely correct, they would not change the relative advantages of one device compared with another.For the purpose of this investigation, as in keeping with other studies (1,6,18,19), 30 s without aerosol production was identified as end nebulization. In the trials using the Updraft II, the generation of intermittent aerosol was limited, and, thus, it was easy to assess this endpoint.…”

mentioning

confidence: 89%

“…Water has a surface tension of 72.8 mN/m (31), and the surface tension of saline is similar, but when mixed with medications, surface tension may differ depending upon the concentration and the specific properties of that agent. Coates et al (3) and Hurley et al (19) have found the surface tension of a 4 mL (20 mg/mL) solution of tobramycin and saline to be 66 mN/m and 54 mN/m, respectively. A study by MacNeish et al (2) compared two different salbutamol preparations, and demonstrated that the preparation with a surface tension similar to that of water yielded a lower nebulized salbutamol output.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Effect of Dead Volume on the Efficiency and the Cost to Deliver Medications in Cystic Fibrosis with Four Disposable Nebulizers

Coates

1999

Canadian Respiratory Journal

View full text Add to dashboard Cite

OBJECTIVES:To evaluate the factors that affect nebulizer efficiency and to compare the relative cost effectiveness of nebulized medications used in the treatment of cystic fibrosis (CF), delivered by four types of disposable jet nebulizers that are widely used in hospitals. DESIGN: The Hudson 1730 Updraft II, Baxter Misty-Neb, Marquest Whisper Jet (WJ), and Marquest Acorn II were evaluated in terms of respirable aerosol output (particles 5 µm or less), nebulizer dead (residual) volume (V D ), and time for complete nebulization using saline, salbutamol and tobramycin at flows of 6 and 8 L/min. The respirable fraction (RF) was determined by laser diffraction, and drug output was calculated from the initial volume and concentration of the drug in the nebulizer minus the product of final drug concentration and the V D following nebulization. COST ANALYSIS: The expected pulmonary deposition (D E ) was estimated, and incorporated with the material and labour costs to determine the cost effectiveness of each type of nebulizer. RESULTS: With a D E greater than two times that of the WJ at a cost of 2.4 times less, the Updraft II proved most efficient and cost effective of all the nebulizers evaluated in this study. CONCLUSIONS:The cost effectiveness of each nebulizer was determined by its efficiency, which in turn was predominantly related to its V D and RF at each flow. The efficiencies of these four devices were different and could not have been predicted from specifications provided by the respective manufacturers.Key Words: Aerosol; Cost effectiveness; Cystic fibrosis; Dead volume; Efficiency; Nebulizer Effet de l'espace mort sur la performance et le coût de l'administration de médicaments aux patients atteints de fibrose kystique du pancréas avec quatre nébuliseurs jetables OBJECTIFS : Évaluer les facteurs qui modifient la performance d'un nébuliseur et comparer la rentabilité relative des médicaments nébulisés et utilisés pour traiter la fibrose kystique du pancréas (FKP) au moyen de quatre types de nébuliseurs jetables largement utilisés dans les hôpitaux. Updraft II, Baxter Misty-Neb, Marquest Whisper Jet (WJ) et Marquest Acorn II ont été évalués relativement à leur production de gouttelettes respirables (particules de 5 µm et moins), à l'espace mort (V D ) résiduel du nébuliseur, et au temps requis pour une nébuli-voir page suivante I nhalational aerosol therapy is widely used as a method to deliver bronchodilators and antibiotics in the treatment of cystic fibrosis (CF). It is commonly accepted that the ideal particle size for pulmonary deposition at the level of the lower airways is within the range of 1 and 5 mm in diameter, and, from this concept, the respirable fraction (RF) of aerosol output has been defined as the mass of drug carried in droplets 5 mm or less (1-3), although it is recognized that data in the pediatric age group are limited and in vitro data may not correlate with in vivo data (4). While the combination of particle size distribution, gas flow driving the nebulizer and the fill volume ...

show abstract

supporting

confidence: 79%