Comparison of Salbutamol Delivery Efficiency for Jet versus Mesh Nebulizer Using Mice

Abstract

Recent reports using a breathing simulator system have suggested that mesh nebulizers provide more effective medication delivery than jet nebulizers. In this study, the performances of jet and mesh nebulizers were evaluated by comparing their aerosol drug delivery efficiencies in mice. We compared four home nebulizers: two jet nebulizers (PARI BOY SX with red and blue nozzles), a static mesh nebulizer (NE-U22), and a vibrating mesh nebulizer (NE-SM1). After mice were exposed to salbutamol aerosol, the levels of salbutamol in serum and lung were estimated by ELISA. The residual volume of salbutamol was the largest at 34.6% in PARI BOY SX, while the values for NE-U22 and NE-SM1 mesh nebulizers were each less than 1%. The salbutamol delivery efficiencies of NE-U22 and NE-SM1 were higher than that of PARI BOY SX, as the total delivered amounts of lung and serum were 39.9% and 141.7% as compared to PARI BOY SX, respectively. The delivery efficiency of the mesh nebulizer was better than that of the jet nebulizer. Although the jet nebulizer can generate smaller aerosol particles than the mesh nebulizer used in this study, the output rate of the jet nebulizer is low, resulting in lower salbutamol delivery efficiency. Therefore, clinical validation of the drug delivery efficiency according to nebulizer type is necessary to avoid overdose and reduced drug wastage.

In vitro delivery efficiencies of nebulizers for different breathing patterns

“…Nebulizers can be classified into three types, i.e., jet, ultrasonic, and mesh nebulizers, according to their operating principles [ 1 – 3 ]. Jet nebulizers have large output rates and mass distribution variations that depending on nozzle and compressor combinations, but are noisy, vibrate in use, and have large residual volumes [ 3 – 5 ]. Mesh nebulizers were developed to overcome these limitations and produce aerosols through holes in a mesh or plate.…”

“…The International Organization for Standardization (ISO) 27427:2013 (Anaesthetic and respiratory equipment-Nebulizing systems and components) defines a method for measuring the outputs and output rates of nebulizers [ 24 ], but it does not include a method for testing drug delivery efficiency. Currently, there is no standard test for measuring drug delivery efficiency, although several in vivo and in vitro respiratory simulator studies have described potential test methods [ 3 , 17 – 23 , 25 – 28 ]. In vivo animal models may not adequately reflect real clinical settings [ 3 ], whereas in vitro respiratory simulator testing provides a more convenient means of testing than in vivo methods and provides reproducible results [ 19 ].…”

Aerosolization Performance of Jet Nebulizers and Biopharmaceutical Aspects

“…For example, nebulization products for chronic and rare diseases are available on the market for coupling with a dedicated tested nebulizer [15,16,17,18]. In fact, variability in dose delivery from different nebulizers has been reported [8,19,20,21,22,23,24].…”

Ventilator-associated pneumonia caused by multidrug-resistant Gram-negative bacteria: understanding nebulization of aminoglycosides and colistin

“…Lung dose is significantly higher with mesh nebulizers whereas nebulization time and residual volume are significantly reduced. These in vitro benefits were confirmed in animals and in patients treated by salbutamol [16][17][18].…”