The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts

BRONCHODILATOR TREATMENT TIME WITH A BREATH-ACTUATED SMALL VOLUME NEBULIZER NEED NOT BE LONGER THAN WITH A CONTINUOUSLY OPERATING NEBULIZER

Dominic P. Coppolo1, Jolyon P. Mitchell2, Rubina S. Ali2, Heather A. Mackay2, Mark W. Nagel2



Background: Breath-actuated nebulizers (BANs) only operate during inhalation, increasing the perception that treatment times for a given mass of inhaled bronchodilator should be longer than with a continuously operating nebulizer. This is of concern in the emergency treatment of patients with severe reversible airways disease where time-to-deliver a given dose is important.

Methods: We investigated the delivery of diluted generic respirator solution albuterol by a continuous jet nebulizer (NebuTech HDN®, Salter Labs., Arvin, CA with a recently introduced BAN (AeroEclipse®-II, Monaghan Medical Corp., Plattsburgh, NY). Both nebulizer groups (n=5) were operated with 8 L/min air supplied at 50 psig with a 3-ml fill (albuterol concentration of 0.83 mg/mL). Aerosol from both nebulizers was sampled onto electret filters using a breathing simulator mimicking adult use (600-ml tidal volume, duty cycle 33%, rate 10 cycles/min). Assay for albuterol was undertaken by UV spectrophotometry. In a parallel study, droplet size distributions were determined by laser diffractometry, so that the fine droplet fraction < 4.7 �m diameter likely to penetrate to the airways of the lungs (FDF) could be determined.

Results: Values of FDF (mean ± SD) for the AeroEclipse®-II BAN and NebuTech HDN were 78.4 ± 1.8% and 51.3 ± 5.2% respectively.

Conclusion: The BAN delivered 490 ± 48.5 μg as fine droplets after 5-min (delivery rate of 98 ± 10 μg/min), compared to 236 ± 23 μg (47 ± 5 μg/min) in the same period by the continuous nebulizer.