Effect of a Nebulizer Holding Chamber on Aerosol Delivery

Sarhan, Rania M.; Elberry, Ahmed A.; Abdelwahab, Nada S.; Rabea, Hoda; Salem, Mohamed; Abdelrahim, Mohamed

doi:10.4187/respcare.06061

Cited by 20 publications

(24 citation statements)

References 27 publications

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“…This method used the amount of drug excreted in urine after 30 min as an index of lung deposition and the amount of drug excreted in urine over a 24-h period after inhalation as an index of systemic absorption. This noninvasive pharmacokinetic method has been used to detect lung deposition of aerosolized drugs to healthy volunteers, 18,28 subjects admitted with an exacerbation of either asthma or COPD, 29 as well as ventilated subjects. 10,14,15,17,21 Similarly, we used this methodology to determine the effect of fill volume and humidification changes on lung deposition and systemic absorption of 2 different nebulizers.…”

Section: In Vivo Methodsmentioning

confidence: 99%

“…[4][5][6][7] The type and position of the aerosol generator, ventilator settings during aerosol delivery, and other variables during NIV have been investigated. 4,5,[7][8][9][10][11][12][13][14][15][16][17][18] Many previously published studies recommended switching off the humidifier while delivering aerosol for improved aerosol delivery. 9,19,20 However, we have shown that there was no significant effect on delivered aerosol associated with this practice during auto-CPAP or duallimb ventilation.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Fill Volume and Humidification on Aerosol Delivery During Single-Limb Noninvasive Ventilation

et al. 2018

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Section: In Vivo Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of Fill Volume and Humidification on Aerosol Delivery During Single-Limb Noninvasive Ventilation

et al. 2018

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“…Particle size is a key parameter in dening the deposition pattern and bio-availability of drug material delivered to the respiratory system using nebulizers. [35][36][37] The optimum particle size for deposition into the lung periphery and the lower airways should be between 1 and 5 mm, whereas, particles with size between 5 and 10 mm deposit mostly in the conducting airways. [38][39][40] Currently, many types of apparatuses have been widely employed for aerosol particle size characterization, such as NGI and Spraytec.…”

Section: Discussionmentioning

confidence: 99%

Characterization and comparison of Re-Du-Ning aerosol particles generated by different jet nebulizers

Zhang

Cheng

et al. 2019

RSC Adv.

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“…These design features improve the efficiency of the nebulizer and decrease aerosol loss due to exhalation and condensation. 1 This chamber results in better aerosol delivery compared to a T-piece with a mouthpiece adapter with the vibrating mesh nebulizers, even when connected to a jet nebulizer. 1 The best delivery was found with the holding chamber designed for use with this device.…”

Section: Introductionmentioning

confidence: 99%

Effect of Oxygen Flow on Aerosol Delivery From a Nebulizer With a Holding Chamber

et al. 2019

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BACKGROUND: A new holding chamber was designed to be used with a vibrating mesh nebulizer to increase the total inhalable dose for patients. It facilitates intermittent and continuous nebulization as well as the optional supply of supplemental oxygen via a T-piece with a mouthpiece adapter. This study aimed to evaluate the effect of oxygen introduction in the new holding chamber on aerosol delivery using a vibrating mesh nebulizer. METHODS: The study was divided into 2 parts. First, the total inhalable dose of 1 mL of a respirable solution (nominal dose of 5,000 gsalbutamol) was determined using a breathing simulator set to provide a tidal volume of 500 mL, a breathing frequency of 15 breaths/min, and an inspiratory:expiratory ratio of 1:1 for adults as a quiet-breathing pattern. Three experimental nebulizer setups were used: a vibrating mesh nebulizer with the holding chamber and oxygen set at 6 L/min, a vibrating mesh nebulizer with the holding chamber and no oxygen, and a vibrating mesh nebulizer with the T-piece. Aerodynamic particle size characterizations were determined using cooled Andersen cascade impaction at an inhalation flow of 15 L/min. Second, we performed an in vivo study involving 12 healthy nonsmoking subjects (6 female) who were > 18 y old with an average FEV 1 > 90% of predicted. Using normal tidal breathing, subjects inhaled 1 mL of nebulized salbutamol (5,000 g) through the vibrating mesh nebulizer with the holding chamber with and without oxygen and through the vibrating mesh nebulizer with a T-piece. To analyze salbutamol content, urine samples were obtained 30 min after dosing as an index of lung deposition, and their urine was cumulatively collected for 24 h as an index of systemic absorption. RESULTS: The holding chamber significantly increased the total inhalable dose or amount of salbutamol excreted in the first 30 min, as well as the amount of salbutamol excreted over a 24-h period compared to the dose received with the vibrating mesh nebulizer with a T-piece (P ‫؍‬ .005, P ‫؍‬ .034, and P ‫؍‬ .02, respectively), and relatively decreased the mass median aerodynamic diameter, although the difference was not significant. However, when oxygen was introduced in the holding chamber, the total inhalable dose, or amount of salbutamol excreted in the first 30 min, significantly decreased compared to use without oxygen (P ‫؍‬ .003, P ‫؍‬ .03 respectively). No significant difference was found between the vibrating mesh nebulizer with the holding chamber with oxygen and the vibrating mesh nebulizer with a T-piece. CONCLUSIONS: The vibrating mesh nebulizer with a holding chamber and without oxygen resulted in much better aerosol delivery compared to vibrating mesh nebulizer with a holding chamber and with oxygen delivery and to the vibrating mesh nebulizer with a T-piece. The use of oxygen with the holding chamber significantly decreased aerosol delivery and its benefit, and recommended flow should be reevaluated.

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Effect of a Nebulizer Holding Chamber on Aerosol Delivery

Cited by 20 publications

References 27 publications

Effects of Fill Volume and Humidification on Aerosol Delivery During Single-Limb Noninvasive Ventilation

Effects of Fill Volume and Humidification on Aerosol Delivery During Single-Limb Noninvasive Ventilation

Characterization and comparison of Re-Du-Ning aerosol particles generated by different jet nebulizers

Effect of Oxygen Flow on Aerosol Delivery From a Nebulizer With a Holding Chamber

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