2006 OPEN FORUM Abstracts
Reduction of nebulization time can be achieved with a new jet nebulizer design
Morice A1, Coughlin S2, Nikander
K3, Smaldone GS4
1Castle Hill Hospital, Cottingham, United Kingdom; 2Respironics RDD, Bognor Regis, United Kingdom; 3Respironics
RDD, Cedar Grove, NJ, USA; 4SUNY, Stony Brook, NY, USA
Background
Nebulization time is one of the factors that
limit a patient's adherence to treatment. A short nebulization time with
preserved clinical efficacy has therefore been one of the major goals in the
development of new nebulizers. We report the results of a clinical study
comparing a new jet nebulizer (Sidestream Turbo, ST) - designed to shorten the
nebulization time - with two existing nebulizer brands (Sidestream, SS; Pari LC
Plus, PLC).
Methods
The study was of an open, randomised, crossover
design including 12 adult patients with asthma (6 males, mean age 44.9 years,
height 170 cm, weight 76.2 kg, baseline FEV1 79.9 % predicted).
Nebulized albuterol was delivered in
cumulative doses of 1.25 mg, 2.5 mg (1.25 + 1.25 mg) and 5.0 mg (2.5 + 2.5 mg).
Nebulization time, lung function (FEV1, FVC, PEF, FEF25-75%,
R5, R20, Rx), plasma albuterol, serum
potassium, ECG, heart rate, finger tremor, and particle size (mass median
aerodynamic diameter, MMAD) were measured.
Results
The nebulization time with the ST nebulizer was
significantly shorter (183 s vs SS
278 s, PLC 226 s; p<0.001), there were no significant differences in any of
the lung function variables (FEV1 at 5.0 mg: ST 3.22 L/s vs SS 3.21 L/s vs PLC 3.23 L/s; adjusted for baseline values), and the plasma albuterol values were significantly lower at
all doses (5.0 mg: ST 1.73 ng/mL vs
SS 2.54 ng/mL, PLC 3.52 ng/mL; p<0.0001). The MMADs were 2.3 µm (ST), 1.3 µm
(SS), and 1.6 µm (PLC). There were no significant differences in serum
potassium, ECG, heart rate or finger tremor values.
Conclusions
The ST
nebulizer had the shortest nebulization time, created the same change in lung
function as the comparator nebulizers, with lower plasma albuterol levels. The reduction in
nebulization time could be of importance to achieve improved adherence to
treatment.