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
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).
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.
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.
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.