The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

EFFECT OF CONSERVER SYSTEMS ON JET NEBULIZER PERFORMANCE

Robert L. Chatburn1, Thomas J. Williams2; 1Respiratory Institute, Cleveland Clinic, Cleveland, OH; 2Strategic Dynamics, Scottsdale, AZ

BACKGROUND: The performance of pneumatic jet nebulizers varies greatly among brands. One key feature of newer nebulizer systems is the addition of a reservoir that conserves aerosol during expiration. Few data are available regarding performance of these conservers. The purpose of this study was to compare 4 different nebulizer configurations (1) a standard continuous flow nebulizer with a simple flex tube reservoir, a standard continuous flow nebulizer with a valve/bag conserver system, a dosimetric nebulizer operated in a breath actuated mode and a dosimetric nebulizer operated in the continuous flow mode. Hypotheses tested were that system efficiency and component efficiencies (i.e., nebulizer, delivery, and conserver efficiency; Respir Care 2007;52:1037) were different among nebulizer configurations. METHODS: Devices evaluated were Westmed VixOne nebulizer with t-tube connector only or 3 different conservers: standard flex tube, Westmed Circularire II or Healthline Medicator Plus (latter 2 are bag/valve systems); Monaghan AeroEclipse II in breath actuated or continuous mode. Nebulized solution was 3 mL normal saline. Breathing was simulated with an ASL 5000 (Ingmar Medical); tidal volume = 500 mL, sinusoidal volume pump at 50% inspiration, frequency = 15/min. Aerosol was collected on a HEPA filter and aerosol quantities measured by weight changes of nebulizer and filter (weight loss due to evaporation was insignificant up to 11 minutes nebulization time). Nebulization was stopped at sputter, defined as the start of the flat portion of the aerosol output/time curve. Mean values were compared with one way ANOVA, P < 0.05 considered significant. RESULTS: Summary data shown in Table. Nebulizer efficiency was the same for VioxOne and AeroEclipse (P = 0.195). Inhaled aerosol was different among nebulizer systems due to conserver performance (P < 0.001). Conservers improved system efficiency for the VixOne (P = 0.006) with bag/valve systems having higher efficiency than the flex tube (P < 0.001). For AeroEclipse, system and delivery efficiency were better for breath actuated mode (P = 0.012). CONCLUSIONS: For the systems tested, bag/valve conservers improve nebulizer performance compared to the standard flex tube. Breath actuated operation is more efficient than continuous nebulization but requires a longer treatment time. Sponsored Research - Study funded by Westmed Inc. Tuscon AZ

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