Factors Influencing the<i>In Vitro</i>Deposition of Tobramycin Aerosol: A Comparison of an Ultrasonic Nebulizer and a High-Frequency Vibrating Mesh Nebulizer

Pedersen, Kenneth Manby; Handlos, Vagn; Heslet, Lars; Kristensen, H. G.

doi:10.1089/jam.2006.19.175

Cited by 26 publications

(13 citation statements)

References 22 publications

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“…The size of the pore, the aerosol chamber, and the reservoir, as well as the output rate of mesh nebulizers, can be adjusted for different drugs in order to optimize aerosol drug delivery to patients (27). Comparisons of mesh and ultrasonic nebulizers demonstrated similar drug delivery in simulated ventilator-dependent patients (29,30). Mesh nebulizers are more efficient than jet nebulizers and can provide higher drug doses to patients.…”

Section: Mesh Nebulizersmentioning

confidence: 99%

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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Section: Mesh Nebulizersmentioning

confidence: 99%

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

Ari

2014

Eurasian J Pulmonol

148

110

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“…Understandably, such an objective is complicated by the many and often interrelated factors that affect nebulizer performance, not least the physicochemical properties of the drug and that of the associated excipient to be administered [67,68], dose, fill volume and concentration [26,[69][70][71], respiratory flow rate [72,73], measurement method (in vitro or in vivo) [26,74], in vitro aerosol collection and measurement method [70,75,76], ambient conditions (e.g., relative humidity) [77] and environmental context (hospital or point-of-care; availability of trained respiratory therapists to administer treatment) [21,78], as well as patient-related factors such as breathing mode (nasal or oral) and pattern (tidal or deep breathing; breath-holding) [67,[79][80][81], severity of illness [21], age group [35,[82][83][84], and physiological profile (e.g., lung morphology) [26,85,86]. Other patient factors such as gender and ethnicity as well as environmental and occupational exposure [87], both past and present, could also be important, although their effects have yet to be studied extensively.…”

Section: Performance Comparison Between Nebulizersmentioning

confidence: 99%

“…Several in vivo studies, both in animals and humans, have also been carried out to assess the performance of ultrasonic nebulizers (see, for example, [8,21,72,89,[91][92][93][94][95][96]). A distinction between animal and human testing must be made as the correlation between results obtained from in vitro and in vivo studies remain tenuous, at best.…”

Section: Performance Comparison Between Nebulizersmentioning

confidence: 99%

Ultrasonic nebulization platforms for pulmonary drug delivery

Yeo¹,

Friend²,

McIntosh³

et al. 2010

Expert Opinion on Drug Delivery

115

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Recent advances in ultrasonic nebulization technology demonstrate significant potential for the development of smart, portable inhalation therapy platforms for the future. Nevertheless, there remain considerable challenges that need to be addressed before such personalized delivery systems can be realized. These have to be addressed across the spectrum from fundamental physics through to in vivo device testing and dealing with the relevant regulatory framework.

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“…The rationale for such variations is not disputed, as they may be required to address specific scientific questions. However, the facts that they exist, that they are frequent, and that they risk influencing the amount or properties of the aerosol generated (18,19,24,27) highlight the need for a way to account for them to adequately reflect and interpret results, as well as to facilitate study comparisons.…”

Section: Discussionmentioning

confidence: 99%

“…Parameters affecting aerosol generation or delivery, such as the choice of nebulizer, the nebulization time, the ventilation profile during nebulization, or the control of humidity, could conceivably influence the amount, properties, delivery, distribution, or deposition of the aerosol generated (18,19,24,27). Nevertheless, results are typically reported in terms of increasing concentrations of methacholine initially used to generate the aerosol, thus neglecting the details of how it was produced and transported.…”

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confidence: 99%

Delivered dose estimate to standardize airway hyperresponsiveness assessment in mice

Robichaud¹,

Fereydoonzad²,

Schuessler³

2015

American Journal of Physiology-Lung Cellular and Molecular Phys

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Airway hyperresponsiveness often constitutes a primary outcome in respiratory studies in mice. The procedure commonly employs aerosolized challenges, and results are typically reported in terms of bronchoconstrictor concentrations loaded into the nebulizer. Yet, because protocols frequently differ across studies, especially in terms of aerosol generation and delivery, direct study comparisons are difficult. We hypothesized that protocol variations could lead to differences in aerosol delivery efficiency and, consequently, in the dose delivered to the subject, as well as in the response. Thirteen nebulization patterns containing common protocol variations (nebulization time, duty cycle, particle size spectrum, air humidity, and/or ventilation profile) and using increasing concentrations of methacholine and broadband forced oscillations (flexiVent, SCIREQ, Montreal, Qc, Canada) were created, characterized, and studied in anesthetized naïve A/J mice. A delivered dose estimate calculated from nebulizer-, ventilator-, and subject-specific characteristics was introduced and used to account for protocol variations. Results showed that nebulization protocol variations significantly affected the fraction of aerosol reaching the subject site and the delivered dose, as well as methacholine reactivity and sensitivity in mice. From the protocol variants studied, addition of a slow deep ventilation profile during nebulization was identified as a key factor for optimization of the technique. The study also highlighted sensitivity differences within the lung, as well as the possibility that airway responses could be selectively enhanced by adequate control of nebulizer and ventilator settings. Reporting results in terms of delivered doses represents an important standardizing element for assessment of airway hyperresponsiveness in mice.

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Factors Influencing theIn VitroDeposition of Tobramycin Aerosol: A Comparison of an Ultrasonic Nebulizer and a High-Frequency Vibrating Mesh Nebulizer

Cited by 26 publications

References 22 publications

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

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

Ultrasonic nebulization platforms for pulmonary drug delivery

Delivered dose estimate to standardize airway hyperresponsiveness assessment in mice

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