A Comparison of the Availability of Tobramycin for Inhalation From Vented vs Unvented Nebulizers

Coates, Allan L.; MacNeish, Clair F.; Lands, Larry C.; Meisner, Dale; Kelemen, Susan; Vadas, Elizabeth B.

doi:10.1378/chest.113.4.951

Cited by 58 publications

(30 citation statements)

References 16 publications

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“…Without a spacer, the deposition will be less, and heavily technique dependent [31]. Pulmonary deposition from dry-powder inhalers is device specific, and breath-enhanced nebulisers deposit much more than unvented ones [32,33]. CFC-free MDIs produce a smaller particle-size distribution and improved (up to 50% of dose) lung deposition compared with those with CFC propellant [34].…”

Section: Methodsmentioning

confidence: 99%

Standardisation of spirometry

Miller¹

2005

Eur Respir J

13,452

9,378

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Section: Methodsmentioning

confidence: 99%

Standardisation of spirometry

Miller¹

2005

Eur Respir J

13,452

9,378

View full text Add to dashboard Cite

“…It might be expected that the model is also valid for unvented ultrasonic nebulizers as the physical principles underlying our model will also pertain to this class of nebulizers. However, the drug output of vented nebulizers is more complex due to the inspiratory flow (Coates et al, 1998b).…”

Section: Resultsmentioning

confidence: 99%

Drug output of unvented jet nebulizers as a function of time

Diederik

Brun

Frijlink

et al. 2003

International Journal of Pharmaceutics

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Nebulizer drug output rate increases during the nebulization. For unvented jet nebulizers, a physical and mathematical model based on the efficiency of the nebulization process is presented for this phenomenon. Formulas are derived for the cumulative drug output and the drug output rate of the nebulization process. The model is compared with the model proposed by Coates et al. [J. Aerosol. Med. 11 (1998) 101]. Both models are supported by experimental literature data. Both models predict the experimental values well but the proposed model allows more easy prediction of the influence of small changes in the nebulization conditions and the calculation of the cumulative drug output for a related process. From literature data it is shown that the efficiency of an unvented jet nebulization process of diluted aqueous solutions is relatively insensitive to small changes in the concentration as well as to small changes in aspiration flow but is sensitive to the humidity of the compressor gas only.

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“…The Hudson 1730 Updraft II nebulizer (Hudson, Temecula, California) was not in use in any of the institutions surveyed; however, it was chosen for this study because of its commercial availability. Previous work (2,3,12) with this device indicated that it was a nebulizer of reasonable performance (more than 50% of the output was in the RF [16]). Each of the nebulizers listed above are widely available throughout North America.…”

Section: Methodsmentioning

confidence: 99%

“…The reusable breath-enhanced type of nebulizers such as the LC Jet Plus (Pari Respiratory Equipment Inc, Midlothian, Virginia), the LC Star (Pari Respiratory Equipment Inc) and the Medic-Aid Ventstream (Medic-Aid Ltd, Pagham, United Kingdom) have been shown to be more efficient in vitro (12) and in vivo (13); however, they are predominantly limited to home use. This is largely because of the issues surrounding sterilization processes for in hospital use, and the significant cost of these reusable (compared with disposable) devices has led to widespread use of standard disposable nebulizers in hospitals.…”

Section: Modèle : Les Nébuliseurs Hudson 1730 Updraft II Baxtermentioning

confidence: 99%

Effect of Dead Volume on the Efficiency and the Cost to Deliver Medications in Cystic Fibrosis with Four Disposable Nebulizers

Coates

1999

Canadian Respiratory Journal

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OBJECTIVES:To evaluate the factors that affect nebulizer efficiency and to compare the relative cost effectiveness of nebulized medications used in the treatment of cystic fibrosis (CF), delivered by four types of disposable jet nebulizers that are widely used in hospitals. DESIGN: The Hudson 1730 Updraft II, Baxter Misty-Neb, Marquest Whisper Jet (WJ), and Marquest Acorn II were evaluated in terms of respirable aerosol output (particles 5 µm or less), nebulizer dead (residual) volume (V D ), and time for complete nebulization using saline, salbutamol and tobramycin at flows of 6 and 8 L/min. The respirable fraction (RF) was determined by laser diffraction, and drug output was calculated from the initial volume and concentration of the drug in the nebulizer minus the product of final drug concentration and the V D following nebulization. COST ANALYSIS: The expected pulmonary deposition (D E ) was estimated, and incorporated with the material and labour costs to determine the cost effectiveness of each type of nebulizer. RESULTS: With a D E greater than two times that of the WJ at a cost of 2.4 times less, the Updraft II proved most efficient and cost effective of all the nebulizers evaluated in this study. CONCLUSIONS:The cost effectiveness of each nebulizer was determined by its efficiency, which in turn was predominantly related to its V D and RF at each flow. The efficiencies of these four devices were different and could not have been predicted from specifications provided by the respective manufacturers.Key Words: Aerosol; Cost effectiveness; Cystic fibrosis; Dead volume; Efficiency; Nebulizer Effet de l'espace mort sur la performance et le coût de l'administration de médicaments aux patients atteints de fibrose kystique du pancréas avec quatre nébuliseurs jetables OBJECTIFS : Évaluer les facteurs qui modifient la performance d'un nébuliseur et comparer la rentabilité relative des médicaments nébulisés et utilisés pour traiter la fibrose kystique du pancréas (FKP) au moyen de quatre types de nébuliseurs jetables largement utilisés dans les hôpitaux. Updraft II, Baxter Misty-Neb, Marquest Whisper Jet (WJ) et Marquest Acorn II ont été évalués relativement à leur production de gouttelettes respirables (particules de 5 µm et moins), à l'espace mort (V D ) résiduel du nébuliseur, et au temps requis pour une nébuli-voir page suivante I nhalational aerosol therapy is widely used as a method to deliver bronchodilators and antibiotics in the treatment of cystic fibrosis (CF). It is commonly accepted that the ideal particle size for pulmonary deposition at the level of the lower airways is within the range of 1 and 5 mm in diameter, and, from this concept, the respirable fraction (RF) of aerosol output has been defined as the mass of drug carried in droplets 5 mm or less (1-3), although it is recognized that data in the pediatric age group are limited and in vitro data may not correlate with in vivo data (4). While the combination of particle size distribution, gas flow driving the nebulizer and the fill volume ...

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A Comparison of the Availability of Tobramycin for Inhalation From Vented vs Unvented Nebulizers

Cited by 58 publications

References 16 publications

Standardisation of spirometry

Standardisation of spirometry

Drug output of unvented jet nebulizers as a function of time

Effect of Dead Volume on the Efficiency and the Cost to Deliver Medications in Cystic Fibrosis with Four Disposable Nebulizers

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