Comparison of Breath-Enhanced to Breath-Actuated Nebulizers for Rate, Consistency, and Efficiency

Leung, Kitty; Louca, Emily; Coates, Allan L.

doi:10.1378/chest.126.5.1619

Cited by 62 publications

(40 citation statements)

References 25 publications

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“…15,18 On the assumption that the solution of MgSO 4 would track with the solution of albuterol, we considered the "inhaled mass" the aerosol collected on and eluted from the filter and quantified via spectrophotometry. 19 Assuming that the deposition of MgSO 4 was proportional to the deposition of albuterol on the inspiratory filter, we calculated the rate of MgSO 4 deposition. We repeated the test with values representative of a small child 20 : tidal volume 100 mL, respiratory rate 15 breaths/min, and T I /T tot 0.4.…”

Section: Methodsmentioning

confidence: 99%

Testing of Nebulizers for Delivering Magnesium Sulfate to Pediatric Asthma Patients in the Emergency Department

Coates¹,

Leung²,

Vecellio

et al. 2011

Respir Care

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BACKGROUND: As the use of intravenous magnesium sulfate (MgSO 4 ) for the treatment of refractory asthma is becoming more common, the incidence of MgSO 4 -related systemic hypotension is also rising. One option is to deliver MgSO 4 via aerosol, but compared to most inhaled medications, which are active in the microgram dose range, the MgSO 4 dose requirement is in the milligram range. This, along with inefficient aerosol delivery systems, may be the reason that some studies have found lack of efficacy with aerosol MgSO 4 . In preparation for a multicenter study of inhaled MgSO 4 in asthmatic children 2-17 years old, we conducted an in vitro study to choose the best MgSO 4 nebulizer system that would be effective over the entire age range. METHODS: We tested the Pari LC Star jet nebulizer, Omron MicroAir vibrating-mesh nebulizer, and the Aeroneb Go vibrating-mesh nebulizer with the Idehaler valve-less holding chamber. Aerosol delivery was via face mask. RESULTS: The Pari LC Star had an appropriate particle size distribution but a very slow aerosol output rate. The Omron MicroAir had an even slower output rate and a larger particle size distribution, which would be inappropriate for smaller children. In vitro lung deposition with the Aeroneb Go with Idehaler was 16.0 ؎ 0.4 mg/min in older children and approximately a fifth of that in toddlers. CONCLUSIONS: The Aeroneb Go with Idehaler was chosen for the multicenter clinical study.

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Section: Methodsmentioning

confidence: 99%

Testing of Nebulizers for Delivering Magnesium Sulfate to Pediatric Asthma Patients in the Emergency Department

Coates¹,

Leung²,

Vecellio

et al. 2011

Respir Care

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“…Os maiores são retidos em anteparos e se juntam ao restante do líquido do reservatório para serem renebulizados, e os menores são inalados. O gás comprimido necessário para o funcionamento desses equipamentos pode ser oriundo de cilindros pressurizados, ou obtido através da utilização de compressores elétricos 21 .…”

Section: Nebulizadores Convencionaisunclassified

“…Os nebulizadores com desempenho melhorado pela respiração (Figura 4) têm uma válvula inspiratória que permite ao paciente inspirar ar adicional durante a inalação, além de reciclar a medicação no reservatório quando não se está inalando 21 . Eles são bem mais eficientes que os antigos, que não possuem esse sistema de reciclagem (nebulização contínua), no qual mais de 70% da droga é perdida no ambiente durante as expirações.…”

Section: Novos Nebulizadoresunclassified

“…Já o I-neb ® (Respironics/Philips, EUA), além de trabalhar em um modo no qual a medicação é oferecida durante a primeira porção da inspiração, executa uma modalidade na qual o paciente é orientado a inspirar lentamente, sendo a droga aerossolizada durante quase toda a inspiração, exceto nos 2 últimos segundos, para maximizar a deposição pulmonar. Como vantagem, também se pode citar o fato de que são silenciosos, portáteis e proporcionam mínimo volume residual, otimizando o uso de medicações como genes e drogas de alto custo 21,[26][27][28] .…”

Section: Novos Nebulizadoresunclassified

“…Vale lembrar, porém, que existem algumas situações nas quais esses são os dispositivos ideais, como por exemplo, na terapêutica inalatória de portadores de fibrose cística 21 .…”

Section: Novos Nebulizadoresunclassified

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Advances in inhalation therapy in pediatrics

Muchão

Filho

2010

J Pediatr (Rio J)

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Objectives: To review the most relevant articles regarding the technical aspects of inhalation therapy, inhalers currently available, and especially major advances in inhalation therapy in pediatrics. Sources:Articles of MEDLINE database from 1983 were reviewed, in addition to book chapters, and the most important studies were selected according to the criteria established for this article. Summary of the findings:Conventional nebulizers have a number of inconveniences, and breath-enhanced and breath-actuated inhalers are more attractive options. Among dry powder inhalers, we highlight those using passive and active powder dispersion mechanisms, which provide higher rates of drug deposition in the lung. Among pressurized metered-dose inhalers, we highlight breath-actuated, breath-coordinated, and velocity-modifying inhalers. These inhalers should be used preferably together with spacers, since the use of spacers produces a twofold increase in pulmonary drug deposition. Conclusions:For children younger than 8 years, pressurized metereddose inhalers with spacers are the most appropriate devices, since they provide a practical approach associated with greater lung deposition. In children older than 8 years who can generate high inspiratory flow rates, dry powder devices are best suited. J Pediatr (Rio J). 2010;86(5):367-376:Nebulizers, pressurized metered-dose inhalers, dry powder inhalers, spacers, pulmonary drug deposition. ResumoObjetivos: Revisar os artigos mais relevantes a respeito dos aspectos técnicos da terapêutica inalatória, dos inaladores disponíveis e principalmente dos principais avanços obtidos na inaloterapia em pediatria. Fontes dos dados:Foram revisados os artigos contidos na base de dados MEDLINE a partir de 1983, além de capítulos de livros, e selecionados os de maior importância de acordo com os critérios estabelecidos para este artigo. Síntese dos dados:Os nebulizadores convencionais apresentam uma série de inconveniências, sendo que inaladores com desempenho melhorado pela respiração e os ativados pela respiração são opções mais atrativas. Dentre os inaladores de pó seco, destacam-se os que utilizam mecanismos passivos e ativos de dispersão de pó, que propiciam maiores taxas de deposição pulmonar das drogas. Entre os inaladores pressurizados dosimetrados destacam-se os ativados pela respiração, os coordenados pela respiração e os modificadores de velocidade. Devem ser usados preferencialmente em conjunto com espaçadores, pois a utilização deste aumenta em até duas vezes a deposição pulmonar das drogas.Conclusões: Para menores de 8 anos, os inaladores pressurizados dosimetrados com espaçadores são os mais adequados, dada a sua praticidade associada à elevada deposição pulmonar que proporcionam. Nos maiores de 8 anos capazes de gerar altos fluxos inspiratórios, os dispositivos de pó são os mais indicados.J Pediatr (Rio J). 2010;86(5):367-376: Nebulizadores, inaladores pressurizados dosimetrados, inaladores de pó seco, espaçadores, deposição pulmonar de drogas. Advances in inhalation the...

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Aerosol Drug Delivery

Hindle

2010

Pharmaceutical Sciences Encyclopedia

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Aerosol drug delivery to the lungs has long been the route of choice for the treatment of respiratory diseases, including asthma and chronic obstructive airway disease. Metered dose inhalers (MDIs), dry powder inhalers (DPIs), and nebulizers have been employed to successfully deliver a wide range of pharmaceuticals principally to the lungs for local action. This article focuses on aerosol drug delivery devices, their development, and future prospects for pulmonary administration.

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Comparison of Breath-Enhanced to Breath-Actuated Nebulizers for Rate, Consistency, and Efficiency

Cited by 62 publications

References 25 publications

Testing of Nebulizers for Delivering Magnesium Sulfate to Pediatric Asthma Patients in the Emergency Department

Testing of Nebulizers for Delivering Magnesium Sulfate to Pediatric Asthma Patients in the Emergency Department

Advances in inhalation therapy in pediatrics

Aerosol Drug Delivery

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