Operating Characteristics of 18 Different Continuous-Flow Jet Nebulizers With Beclomethasone Dipropionate Liposome Aerosol

Waldrep, J. Clifford; Keyhani, Keyvan; Black, Melanie; Knight, Vernon

doi:10.1378/chest.105.1.106

Cited by 74 publications

(22 citation statements)

References 21 publications

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“…The rate of aerosol production and the characteristics of the aerosol generated by a nebuliser differ between devices [119] and depend on ventilator mode [120], pulmonary mechanics [120], inspiratory flow rate [121] and distance from the endotracheal tube [122].…”

Section: Intubated and Mechanically Ventilated Patientsmentioning

confidence: 99%

What the pulmonary specialist should know about the new inhalation therapies

Laube

Janssens

Jongh

et al. 2011

European Respiratory Journal

683

677

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A collaboration of multidisciplinary experts on the delivery of pharmaceutical aerosols was facilitated by the European Respiratory Society (ERS) and the International Society for Aerosols in Medicine (ISAM), in order to draw up a consensus statement with clear, up-to-date recommendations that enable the pulmonary physician to choose the type of aerosol delivery device that is most suitable for their patient. The focus of the consensus statement is the patientuse aspect of the aerosol delivery devices that are currently available.The subject was divided into different topics, which were in turn assigned to at least two experts. The authors searched the literature according to their own strategies, with no central literature review being performed. To achieve consensus, draft reports and recommendations were reviewed and voted on by the entire panel.Specific recommendations for use of the devices can be found throughout the statement. Healthcare providers should ensure that their patients can and will use these devices correctly. This requires that the clinician: is aware of the devices that are currently available to deliver the prescribed drugs; knows the various techniques that are appropriate for each device; is able to evaluate the patient's inhalation technique to be sure they are using the devices properly; and ensures that the inhalation method is appropriate for each patient.

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Section: Intubated and Mechanically Ventilated Patientsmentioning

confidence: 99%

What the pulmonary specialist should know about the new inhalation therapies

Laube

Janssens

Jongh

et al. 2011

European Respiratory Journal

683

677

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“…The need for a power source and long treatment times, the required setup and cleaning, significant variations in performance between manufacturers, and the loss of expensive drug in considerably high residual volumes are significant drawbacks to jet nebulizers (72)(73)(74)(75). In vitro data have demonstrated that drug delivery from a jet nebulizer can be optimized via operation with a nitrogen-oxygen mixture with particles entrained in a helium-oxygen operating circuit (76).…”

Section: Delivery Devicesmentioning

confidence: 99%

Inhaled Antibiotics for Gram-Negative Respiratory Infections

et al. 2016

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SUMMARYGram-negative organisms comprise a large portion of the pathogens responsible for lower respiratory tract infections, especially those that are nosocomially acquired, and the rate of antibiotic resistance among these organisms continues to rise. Systemically administered antibiotics used to treat these infections often have poor penetration into the lung parenchyma and narrow therapeutic windows between efficacy and toxicity. The use of inhaled antibiotics allows for maximization of target site concentrations and optimization of pharmacokinetic/pharmacodynamic indices while minimizing systemic exposure and toxicity. This review is a comprehensive discussion of formulation and drug delivery aspects,in vitroand microbiological considerations, pharmacokinetics, and clinical outcomes with inhaled antibiotics as they apply to disease states other than cystic fibrosis. In reviewing the literature surrounding the use of inhaled antibiotics, we also highlight the complexities related to this route of administration and the shortcomings in the available evidence. The lack of novel anti-Gram-negative antibiotics in the developmental pipeline will encourage the innovative use of our existing agents, and the inhaled route is one that deserves to be further studied and adopted in the clinical arena.

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“…adequately. [7][8][9][10][11] Record keeping is best done on a computer system which allows both patient and compressor details to be identified and enables Nebuliser units There are many units available which vary in compressors to be recalled for an annual service. There may be a need to identify clerk or terms of output over time and particle size profile.…”

Section: Iel 601-1 (1988) a Compressor Is Requiredmentioning

confidence: 99%

Running a domiciliary nebuliser service

Wilson¹,

Muers²

1997

Thorax

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The range of conditions to be treated needs to Local guidelines should be in place for the provision of nebulisers, a loan service, emerbe identified and selection criteria determined. These should be made widely known to clini-gency provision, and a system for repair, servicing and maintenance. cians both within the hospital and in general practice. A specimen list is shown in table 1. Provision of equipment Organisation of the serviceGeneral practitioners usually do not have the Nebuliser services throughout the UK serve resources to provide an adequate nebuliser serdifferent populations and vary considerably in vice for the few patients in a practice for whom their organisation. 1 Clearly there cannot be a long term treatment is suitable, and it is reset of guidelines to satisfy the needs of everyone, commended that these patients are referred but it is important that there are guidelines in to a hospital for assessment and provision of place that satisfy local needs and lead to a equipment. standardised, effective, and efficient service It is the responsibility of the NHS to provide which encompasses within it nationally re-nebuliser equipment if the prescribing physcognised standards.ician decides that it is a necessary part of NHS The service is best organised and ad-treatment. 4 It is also the responsibility of the ministered centrally for any given trust, catch-NHS to provide a repair and maintenance ment area, or district 1 2 and should be under service for the equipment it provides, including the supervision of a designated consultant or a electrical safety checks. 5 group of consultants with a consensus view.As yet, not all trusts or districts provide an Day to day management of the service should adequate nebuliser service. 1 In many cases the be under the control of a named individual provision of equipment relies heavily on volwho could, for example, be a respiratory liaison untary donations. This is clearly an unsister/nurse, a physiotherapist, or a physio-satisfactory situation. logical measurement technician. A mechanismThe cost of a nebuliser service can be con-

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Operating Characteristics of 18 Different Continuous-Flow Jet Nebulizers With Beclomethasone Dipropionate Liposome Aerosol

Cited by 74 publications

References 21 publications

What the pulmonary specialist should know about the new inhalation therapies

What the pulmonary specialist should know about the new inhalation therapies

Inhaled Antibiotics for Gram-Negative Respiratory Infections

Running a domiciliary nebuliser service

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