aaBronchial challenge tests using sequential doses of nebulized substances are used in the assessment of individual asthmatics and in epidemiological studies. Reproducibility and comparability between centres depends critically on the accurate calibration of nebulizer output. Many other variables have to be considered, such as patient cooperation, inhalation time and particle size. RYAN et al. [1] has suggested that variations in output are critical in determining differences in the results of aerosol provocation tests.The simplest method of measuring aerosol output is by measuring weight loss. This may overestimate aerosol output because of coincidental weight loss due to evaporation. The alternative is to measure the solution actually nebulized, collecting it by impaction onto a filter. Evaporation precludes the use of weight gain but elution with the use of a chemical tracer has been shown to be satisfactory [2]. The use of a radioactive tracer may be less cumbersome, provided proper facilities are available. We wanted to assess the impact of evaporation on nebulizer output in the context of intermittent nebulization by dosimeter as used in bronchial challenge studies. We have tested and present a new method using a radioactive tracer, which we believe is more accurate than direct weighing. We have used this to assess the likely impact of evaporation on the delivered dose from intermittent nebulization.
Materials and methods
Dosimeter and nebulizersThe MEFAR Dosimeter MB3 (MEFAR, Brescia, Italy) was used. Characteristics and performance have been reported elsewhere [3]. The dosimeter pneumatic system delivered an output pressure of 88.2-99.3 kPa at an airflow of 0.37-0.42 L·s -1 . Three nebuliser models were used: 1) A1-A6 MEFAR, median diameter 2.0 µm; 2) G1-G2 Micro-Neb III (Lifecare Market Harborough, UK), median diameter 2.8 µm [4]; and 3) B1-B2 Sidestream (Medic-aid Bognor Regis, UK), median diameter 2.3 µm [4].Inhalation time, pause time and the number of inhalations were kept constant. Each run consisted of 20 nebulizations of 1 s with an 8 s pause time.
Nebulizer solutionA standard solution (4 mL) was dispensed into each nebulizer. This consisted of technetium (Tc) 99m-pertechnetate ( 99m TcO 4 ) (molecular weight (MW) 163) diluted in normal saline at a concentration of 1.5 kBq·mL -1 .
A new method for measuring aerosol nebulizer output using radioactive tracers. A.A. Gatnash, S.T. Chandler, C.K. Connolly. ©ERS Journals Ltd 1998.ABSTRACT: Reproducibility and comparability of bronchial challenge tests depends critically on accurate assessment of nebulizer output. Evaporation during nebulization means that simple weighing is inaccurate, overestimating the delivered dose of active ingredient. We wanted to quantify this effect in the context of intermittent nebulization, using a dosimeter as used in bronchial provocation tests.Output of three types of nebulizer, from the MEFAR dosimeter, was measured by radioactive tracer, using a standard solution of technetium-99m-pertechnetate (1.5 kBq·mL -1 ) in 4 mL...