The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

CLINICAL COMPARISON OF A HIGH EFFICIENCY NEBULIZER VS. TRADITIONAL SMALL VOLUME NEBULIZER ON ASTHMATIC PATIENTS IN AN URBAN EMERGENCY DEPARTMENT.

G. Hamilton1, C. Hoerr1, M. Kollef2, K. Stuckey1, H. Schmidt1, O. Hossin1, C. Simmons1, L. Bammarito1, S. Abberton1, K. Swift1


Background: Traditional small volume jet nebulizers have been shown to be inefficient, deliver a wide rang of particle sizes, and have prolonged dosing times. In vitro studies of new aerosol delivery devices have demonstrated higher respirable dosages at lower dosing times when compared to traditional small volume nebulizers. To test these results, we compared the clinical performance of the AeroEclipse II BAN (Monaghan Medical) to the Misty Max 10(AirLife) small volume nebulizer.

Method: Asthma patients receiving nebulizer therapy were retrospectively analyzed. Patients seeking treatment during the test time period received five minute timed treatments with the AeroEclipse II nebulizer in the ‘continuous’ mode. Patients seen during the control time period received standard nebulizer treatments with the Misty Max 10. Results for clinical response and resource utilization were compared between the test group and the control group.

Results: Both the test and control group contained 127 patients. Each group contained 77 females and 50 males. No statistical difference was noted in age between the test group (38.73 ± 14.22) and control group (36.65 ± 14.30) when analyzed using a Student T-test (p>0.05). Patients treated in the test group showed significant improvement in the average peak flow change when compared to the control group (51.48 ± 56.25 vs. 38.61 ± 47.54) (Kruskal Wallis Test, p<0.05). No statistical difference was noted in the total number of treatments administered to each group during each time period (test:206, control:219)(Kruskal Wallis Test, p>0.05). Admission rate differed only slightly between the two groups(test:11.8%, control:14.2%).

Conclusions: We demonstrated that the AeroEclipse II showed significant improvement in average peak flow change when compared to the Misty Max 10 in 127 asthma patients receiving nebulizer therapy. In addition, although no statistical difference was noted, patients receiving therapy via the high efficiency nebulizer had lower average treatments per patient and a lower admission rate. Although the cost of the AeroEclipse II far exceeds the cost of the Misty Max 10 ($4.25 vs. $0.85), labor savings resulted in a $60 net cost savings per 127 patients seen. Overall, our analysis concluded that the use of the AeroEclipse II showed significant improvement in clinical response in asthma patients in less time and at a lower cost.

 N = Avg. Age Avg. Peak Flow Δ Total Tx's Avg. Tx's/Patient Admissions
Test Group (AerEclipse II BAN) 127 38.73 51.48 206 1.622 15(11.8%)
Control Group (Misty Max 10) 127 36.65 38.61 219 1.72 18(14.2%)



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