In vitro Comparison of DeVilbiss Jet and Ultrasonic Nebulizers

Newman, Stephen P.; Pellow, Peter G.D.; Clarke, S W

doi:10.1378/chest.92.6.991

Cited by 44 publications

(9 citation statements)

References 10 publications

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“…For methacholine provocation tests, the DeVilbiss 646 is the nebuliser of recommendation [16]. This nebuliser can yield variable particle sizes depending mainly on its output flow rate [17] and at a flow rate of 12 L?min -1 , methacholine is aerosolised to particles of 3.7 mm [18]. Particles of 5-7 mm in mass mean aerodynamic diameter (MMAD), as produced by an ultrasonic nebuliser, do not reach the lower airways, in contrast to particles of 2-3 mm MMAD produced by a jet nebuliser [19].…”

mentioning

confidence: 99%

Particle size matters: diagnostics and treatment of small airways involvement in asthma

Cohen¹,

Postma²,

Douma³

et al. 2010

Eur Respir J

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Small airways are an important site of inflammation and obstruction in asthma, which contributes to the severity of airway hyperresponsiveness (AHR) that is usually measured by nebulisation of large-particle stimuli. We investigated whether small and large particle sizes of aerosolised adenosine monophospate (AMP) provoke similar severity of AHR. Additionally, effects of the small-particle inhaled corticosteroid (ICS) ciclesonide and large-particle ICS fluticasone on AHR to large-and small-particle size AMP were assessed.After a 4-week run-in period using open-label fluticasone (100 mg b.i.d.), 37 mild-to-moderate asthmatics underwent provocations with standard-size (3.7 mm), large-particle (9.9 mm) and smallparticle (1.06 mm) AMP. Subjects received 4-week ciclesonide (160 mg s.i.d.) or fluticasone (100 mg b.i.d.) treatment (double-blind and double-dummy) followed by large-and small-particle AMP provocation.Small-particle AMP induced a 20% decrease in forced expiratory volume in 1 s (FEV1) at a significantly higher dose than large-particle AMP. Ciclesonide and fluticasone had comparable effects on AMP provocations. Not all subjects reached the provocative concentration causing a 20% fall in FEV1 (PC20) at the highest AMP dose. In those who did, ciclesonide improved smallparticle AMP PC20 by 1.74 doubling doses (DD) (p50.03), whereas fluticasone did not. Conversely, fluticasone improved large-particle AMP PC20 significantly (1.32 DD; p50.03), whereas ciclesonide did not.Small-particle AMP provocation appears to be a promising tool to assess changes in small airway inflammation. Future adjustments are necessary taking into account the very small particle size used, with large exhaled fractions. In asthmatics reaching a PC20 with small-and largeparticle AMP provocations, ciclesonide improves hyperresponsiveness to small particle size AMP, and fluticasone to large particle size. This warrants further research to target provocations and treatment to specific airway sizes.

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mentioning

confidence: 99%

Particle size matters: diagnostics and treatment of small airways involvement in asthma

Cohen¹,

Postma²,

Douma³

et al. 2010

Eur Respir J

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“…Additional advantages are its quiet operation and shorter administration times. 12,19 Compared with jet nebulizers that take 15-30 minutes to complete administration, ultrasonic nebulizers take approximately 10 minutes. 19 Some barriers to routine use of ultrasonic nebulizers are cost, high maintenance, the need to clean the unit after each use, and possible denaturation of active molecules during aerosolization.…”

Section: Ultrasonic Nebulizersmentioning

confidence: 99%

Consensus Summary of Aerosolized Antimicrobial Agents: Application of Guideline Criteria

Lê

Ashley

Neuhauser³

et al. 2010

Pharmacotherapy

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Aerosolized delivery of antimicrobial agents is an attractive option for management of pulmonary infections, as this is an ideal method of providing high local drug concentrations while minimizing systemic exposure. With the paucity of consensus regarding the safety, efficacy, and means with which to use aerosolized antimicrobials, a task force was created by the Society of Infectious Diseases Pharmacists to critically review and evaluate the literature on the use of aerosolized antiinfective agents. This article summarizes key findings and statements for preventing or treating a variety of infectious diseases, including cystic fibrosis, bronchiecstasis, hospital-acquired pneumonia, fungal infections, nontuberculosis mycobacterial infection, and Pneumocystis jiroveci pneumonia. Our intention was to provide guidance for clinicians on the use of aerosolized antibiotics through evidence-based pharmacotherapy. Further research with well-designed clinical trials is necessary to elucidate the optimal dosage and duration of therapy and, of equal importance, to appreciate the true risks associated with the use of aerosolized delivery systems.

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“…Entretanto, o calor gerado pelo cristal pode desnaturar muitas medicações, particularmente proteínas, e o cristal pode se quebrar, fato este que é frequentemente difícil de ser detectado 19,20 .…”

Section: Nebulizadores Convencionaisunclassified

Advances in inhalation therapy in pediatrics

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2010

J Pediatr (Rio J)

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Objectives: To review the most relevant articles regarding the technical aspects of inhalation therapy, inhalers currently available, and especially major advances in inhalation therapy in pediatrics. Sources:Articles of MEDLINE database from 1983 were reviewed, in addition to book chapters, and the most important studies were selected according to the criteria established for this article. Summary of the findings:Conventional nebulizers have a number of inconveniences, and breath-enhanced and breath-actuated inhalers are more attractive options. Among dry powder inhalers, we highlight those using passive and active powder dispersion mechanisms, which provide higher rates of drug deposition in the lung. Among pressurized metered-dose inhalers, we highlight breath-actuated, breath-coordinated, and velocity-modifying inhalers. These inhalers should be used preferably together with spacers, since the use of spacers produces a twofold increase in pulmonary drug deposition. Conclusions:For children younger than 8 years, pressurized metereddose inhalers with spacers are the most appropriate devices, since they provide a practical approach associated with greater lung deposition. In children older than 8 years who can generate high inspiratory flow rates, dry powder devices are best suited. J Pediatr (Rio J). 2010;86(5):367-376:Nebulizers, pressurized metered-dose inhalers, dry powder inhalers, spacers, pulmonary drug deposition. ResumoObjetivos: Revisar os artigos mais relevantes a respeito dos aspectos técnicos da terapêutica inalatória, dos inaladores disponíveis e principalmente dos principais avanços obtidos na inaloterapia em pediatria. Fontes dos dados:Foram revisados os artigos contidos na base de dados MEDLINE a partir de 1983, além de capítulos de livros, e selecionados os de maior importância de acordo com os critérios estabelecidos para este artigo. Síntese dos dados:Os nebulizadores convencionais apresentam uma série de inconveniências, sendo que inaladores com desempenho melhorado pela respiração e os ativados pela respiração são opções mais atrativas. Dentre os inaladores de pó seco, destacam-se os que utilizam mecanismos passivos e ativos de dispersão de pó, que propiciam maiores taxas de deposição pulmonar das drogas. Entre os inaladores pressurizados dosimetrados destacam-se os ativados pela respiração, os coordenados pela respiração e os modificadores de velocidade. Devem ser usados preferencialmente em conjunto com espaçadores, pois a utilização deste aumenta em até duas vezes a deposição pulmonar das drogas.Conclusões: Para menores de 8 anos, os inaladores pressurizados dosimetrados com espaçadores são os mais adequados, dada a sua praticidade associada à elevada deposição pulmonar que proporcionam. Nos maiores de 8 anos capazes de gerar altos fluxos inspiratórios, os dispositivos de pó são os mais indicados.J Pediatr (Rio J). 2010;86(5):367-376: Nebulizadores, inaladores pressurizados dosimetrados, inaladores de pó seco, espaçadores, deposição pulmonar de drogas. Advances in inhalation the...

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In vitro Comparison of DeVilbiss Jet and Ultrasonic Nebulizers

Cited by 44 publications

References 10 publications

Particle size matters: diagnostics and treatment of small airways involvement in asthma

Particle size matters: diagnostics and treatment of small airways involvement in asthma

Consensus Summary of Aerosolized Antimicrobial Agents: Application of Guideline Criteria

Advances in inhalation therapy in pediatrics

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