2001 OPEN FORUM Abstracts
AN IN VITRO COMPARISONOF NEBULIZER PERFORMANCE IN NORMAL BREATHING AND ACUTE AIRFLOW OBSTRUCTION
Arzu Ari, M.S., CRT,CPFT,J.L.Rau Ph.D., RRT, Ruben Restrepo, MD, RRT, Cardiopulmonary Care Sciences, Georgia State University, Atlanta, GA
Introduction:Previous research has shown that different models of nebulizers vary considerablyin performance.1 Purpose: The purpose of this study is to compare the performanceof different nebulizers in vitro under normal versus simulated emergency departmenttreatment of acute severe airflow obstruction.
Methods: Three samples offive different brands of nebulizer (Misty-Neb, Sidestream, Circulaire?,PariLCD, AeroEclipse?) were compared under two different breathingpatterns that represent a normal breathing and acute airflow obstruction. Eachnebulizer was filled with a 3 ml unit dose of albuterol (Proventil, 2.5 mg),and powered by oxygen at 8 L/min. Nebulizers were connected to the Hans RudolphModel 1100 Breathing Simulator using a USP throat. Fine particle fraction (FPF)wasestimated by collecting drug on a filter between the breathing simulator andthe USP throat. Time to sputter was measured using a stopwatch. Drug collectedon the filters was analyzed using a spectrophotometer at 276 nm.
Results: FPF as a percentof the delivered dose and time to sputter are summarized as means (SD):
|17.2%(0.4)||15.8% (2.7)||15.2% (4.1)||8.7% (0.9)||38.7% (1.3)|
|11.91 (0.3)||9.51 (0.06)||8.36 (1.18)||7.03 (0.45)||14.44 (1.10)|
|Acute Airflow Obst.|
|FPF, %||16.8% (2.9)||11.4% (0.7)||21.7% (3.3)||5.9% (1.5)||24.6% (1.9)|
|Time,min||11.92 (0.57)||9.23 (0.20)||8.86 (0.37)||6.00 (0.42)|
There were significant differencesof FPF% among the 5 brands, determined by 1-way ANOVA, for both normal (p<0.001)and acute obstruction (p<0.001) patterns. Conclusion: The nebulizer performancechanges in two breathing patterns. This should be considered by respiratorycare personnel who make purchase decisions and policies regarding small volumehand held nebulizers. Finally our study is a bench study( therefore, it is necessaryto evaluate the clinical implications of our findings.
1. Hess D, Fisher D. Medicationnebulizer performance. Chest 1996(110 (2): 498-505.