Is Combihaler usable for aerosol delivery in single limb non-invasive mechanical ventilation?

Performance of Large Spacer Versus Nebulizer T-Piece in Single-Limb Noninvasive Ventilation

“…This was consistent with previous in vitro data that reported no significance difference between fine particle dose (Յ5 m and Յ3 m) of the vibrating mesh nebulizer with both the T-piece and the large spacer. 14 The coefficient of variation for urinary salbutamol was reported to be relatively high, as seen in our results. 46 This and the expected 35% intra-and interpatient variability contributed to the lack of statistical significance in our small patient population.…”

“…[10][11][12][13] In a previous in vitro study, we reported that the standard T-piece and large spacer were equally efficient for salbutamol delivery by a vibrating mesh nebulizer in a single-limb NIV under nonhumidified conditions. 14 In vitro methods that study the aerodynamic characteristics and fate of aerosol by using a lung simulator model are thought to offer some degree of guidance to clinical delivery and response. However, inhaled doses determined in vitro do not accurately account for the variability of breath parameters in vivo, and the lung dose in vivo is lower than filters because lungs exhale more aerosol than do collecting filters.…”

Effects of Fill Volume and Humidification on Aerosol Delivery During Single-Limb Noninvasive Ventilation

“…Salbutamol entrained on the filter was described as total inhaled dose (aerosol emitted) and assayed for salbutamol using previously validated highperformance liquid chromatography. 12,13,25,26,32,33 We used the 25 mm ϫ 4.6 mm Zorbax Eclipse Plus C18 and the ODS1 column (Agilant), through which the mobile phase consisted of a mixture of acetonitrile and water (0.1% phosphoric acid) (90:10, v/v) was pumped at 1 mL/min using the 1260 Infinity preparative pump (G1361A, Agilant) the 1260 Infinity Diode array detector VL (G131SD, Agilant) was set at 225 nm with an injection volume 100 L. Calibration solutions ranged from 4 to 100 g/mL (weight/volume). Limit of detection was 0.35 g/mL, and the lower limit of quantification was 2.55 g/mL.…”

Effect of a Nebulizer Holding Chamber on Aerosol Delivery

“…With the jet nebulizer, the position of the holding chamber was above the jet nebulizer, as shown in Figure 1B, so any condensation on the walls will return to the nebulizer reservoir chamber to be re-nebulized. 8,9,23,24 The significant increases (P Ͻ .001) of the amount left in the holding chamber compared with that in the T-piece with the Pro support this rationale and suggest that the 25% increase in the aerosol emitted with the Pro-holding chamber was from the exhaled aerosol not the condensate. 24 The Solo-holding chamber resulted in much better delivery than the Pro and the jet nebulizer or even the Solo itself with its T-piece.…”