Effects of Repetitive Use and Cleaning Techniques of Disposable Jet Nebulizers on Aerosol Generation

Standaert, T. A.; Morlin, Gregory; Williams‐Warren, Judy; Joy, Pamella; Pepe, Margaret S.; Weber, Allan; Ramsey, Bonnie W.

doi:10.1378/chest.114.2.577

Cited by 43 publications

(31 citation statements)

References 24 publications

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“…In agreement with Standaert et al, 21 we found that all compressor/nebulizer combinations maintained baseline MMAD. Their study was limited to 100 runs, and ours was 14 obtained using arformoterol inhalation solution.…”

Section: Discussionsupporting

confidence: 93%

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Longitudinal Evaluation of Compressor/Nebulizer Performance

2013

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Section: Discussionsupporting

confidence: 93%

“…[16][17][18][19][20] Standaert et al 21 determined particle size distribution and output rate of the Pari LC durable nebulizer after 100 runs and reported that particle size remained stable.…”

Section: What This Paper Contributes To Our Knowledgementioning

confidence: 99%

Longitudinal Evaluation of Compressor/Nebulizer Performance

2013

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“…Mesh nebulizers, such as the e-Flow, should be repeatedly washed and disinfected in order to prevent possible microbiological contamination with cystic fibrosis patients. Previous studies showed that the performance of jet nebulizers was influenced by washing and disinfecting (34)(35)(36). However, no significant performance change in the e-Flow was found (37).…”

Section: Active Mesh Nebulizersmentioning

confidence: 91%

Jet, Ultrasonic, and Mesh Nebulizers: An Evaluation of Nebulizers for Better Clinical Outcomes

Ari

2014

Eurasian J Pulmonol

148

110

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For over a century, nebulizers have been commonly used to deliver aerosolized medications in the treatment of patients with pulmonary diseases. They are the aerosol device of choice when patients can not coordinate inhalation and actuation needed for the use of the pressurized metered-dose inhalers (pMDIs) or are not able to provide the necessary inspiratory flow required by the dry powder inhaler (DPI) for effective aerosol drug delivery. Three types of nebulizers exist: (1) jet nebulizers, (2) ultrasonic nebulizers, and (3) mesh nebulizers. The purpose of this paper is to explain the types of nebulizers available on the market and to evaluate their efficiencies in aerosol drug delivery while suggesting strategies for the optimal treatment of patients with pulmonary diseases. Keywords: Nebulizers, aerosols, inhalation therapyDelivery of aerosolized drugs was revolutionized in the 1950s with the development of nebulizers and pressurized metered-dose inhalers. Nebulizers transform liquid formulations and suspension into medical aerosol. In the past few years, there have been advances in the development of new nebulizers that hold the promise to improve aerosol drug delivery to patients with pulmonary diseases. Nebulizers are divided into three categories: (1) jet nebulizers, (2) ultrasonic nebulizers, and (3) mesh nebulizers. While jet nebulizers are commonly used for the treatment of patients with pulmonary diseases, they are bulky and require a power source. Due to aerosolized droplets and solvent vapor that saturates the outgoing air, jet nebulizers cool the drug solution in the nebulizer and increase solute concentration in the residual volume. Although ultrasonic nebulizers are more efficient and compact than jet nebulizers, they can not be used to deliver proteins or suspensions. With the development of mesh nebulizers that use lower-frequency waves, heating issues that denature proteins during aerosol therapy are eliminated. Also, it has been shown that mesh nebulizers are suitable for delivery of suspensions, liposomes, and nucleic acids (1-5). Since there is a large number of nebulizers in each category that have been introduced to the market, the purpose of this paper is to explain the types of nebulizers available and to evaluate their efficiencies in aerosol drug delivery. In addition, strategies for optimal inhalation treatment of patients with pulmonary diseases will be investigated. JET NEBULIZERSTraditionally, jet nebulizers have been used for the treatment of pulmonary diseases. These nebulizers require 2 to 10 L/min of pressurized gas to draw medication up through a capillary tube from the nebulizer reservoir in order to generate a wide range of particle sizes that are blasted into one or more baffles, which take larger particles out of suspension and return them to the reservoir.Jet nebulizers are effective in delivering formulations that can not be delivered with pressurized metered-dose inhalers (pMDIs) and dry powder inhalers (DPIs). For instance, antibiotics, mucolytics, liposomal f...

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“…Furthermore, exhaled antibiotics should be discharged through a tube to the outside air or trapped in a filter, in order not to contaminate the surroundings of the patient. In some hospitals it is recommended that inhalations are performed in a separate area [182]. With new nebulizers releasing the drug during the first part of inspiration only (adaptive aerosol delivery, e.g.…”

Section: Nebulized Antipseudomonal Antibiotic Therapy In Cystic Fibrosismentioning

confidence: 99%

Antibiotic therapy against Pseudomonas aeruginosa in cystic fibrosis: a European consensus

Döring¹,

Conway²,

Heijerman³

et al. 2000

Eur Respir J

559

478

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Cystic fibrosis (CF) is the most common lethal hereditary disorder with autosomal recessive heredity in caucasians. The majority of CF patients suffer from chronic respiratory infection with the opportunistic bacterial pathogen Pseudomonas aeruginosa. No consensus among clinicians has been reached so far concerning antibiotic treatment against P. aeruginosa in CF patients.Consensus answers to 24 important questions in this context, based on current evidence, are presented, given by a panel of 34 European experts. Questions addressed and answered are: The diagnosis of P. aeruginosa lung colonization in CF; The impact of P. aeruginosa on the clinical state of CF patients; The assessment of P. aeruginosa susceptibility against antibiotics and the importance of these results for the clinician; The use of monotherapy versus combination therapy; The development of microbial resistance; The achievement of optimal airway concentrations; The effects of subinhibitory concentrations of antibiotics on P. aeruginosa; Statements on the pharmacokinetics of antibiotics in CF patients; Recommendations for doses and dosing intervals and length of treatment regimens; and Toxic side effects due to repeated antibiotic therapy was addressed.The expert panel answered further questions on the use of fluoroquinolones in children with CF, on the administration of nebulized antibiotics and whether prevention of P. aeruginosa lung colonization is possible in CF using antibiotic therapy.Problems of antibiotic therapy at home and in the hospital were addressed, a consensus statement on regular maintenance treatment, or treatment on demand, was given and different routes of administration of antibiotics were recommended for different clinical situations.Finally, the factors which determine the choice of the antibiotic, the dosage, and the duration of the treatment in cystic fibrosis patients were addressed and the design of future antibiotic studies in the context of Pseudomonas aeruginosa lung infection in cystic fibrosis patients were recommended. Eur Respir J 2000; 16: 749±767.

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Effects of Repetitive Use and Cleaning Techniques of Disposable Jet Nebulizers on Aerosol Generation

Cited by 43 publications

References 24 publications

Longitudinal Evaluation of Compressor/Nebulizer Performance

Longitudinal Evaluation of Compressor/Nebulizer Performance

Jet, Ultrasonic, and Mesh Nebulizers: An Evaluation of Nebulizers for Better Clinical Outcomes

Antibiotic therapy against Pseudomonas aeruginosa in cystic fibrosis: a European consensus

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