Introduction:
The combination of multiple drugs in a nebulizer can prolong treatment time and lead to complicated dosing. High-efficiency nebulizers are engineered to enhance the delivery of medication to the distal airways while ensuring aerosol particles remain within the respirable range, typically under 5 μm.
Aim:
This study sought to evaluate and compare three nebulizers by analyzing the in-vitro Fine Droplet Mass (FDM <4.7 μm) as well as the aerosol properties of an ipratropium/albuterol combination over time.To compare the performance of three nebulizers—Breath Actuated Jet Nebulizers, Jet Nebulizer, and Jet Nebulizer with Reservoir Bag.
Methods:
- Study Design: In-vitro performance comparison
- Nebulizers tested: Breath Actuated Jet Nebulizers, Jet Nebulizer, Jet Nebulizer with Reservoir Bag (n = 5 each)
- Medication: 1 vial of combination of ipratropium bromide 0.5 mg/ albuterol sulfate 3.0 mg
- Breathing Simulation:
- Tidal volume: 500 mL
- Breathing rate: 10 cycles/min
- Duty cycle: 33%
- Aerosol Collection:
- Filter placed between nebulizer and test lung
- Filters changed every minute; output measured by HPLC
- Aerosol Measurements:
- Fine Droplet Fraction <4.7 μm diameter (FDF<4.7 μm) measured using a laser diffractometer.
- FDM<4.7 μm calculated as: Filter mass × FDF<4.7 μm.
Results:
|
Nebulizer |
Mean FDF < 4.7 μm |
|
Breath Actuated Jet Nebulizers |
84.5% |
|
Jet Nebulizer |
52.6% |
|
Jet Nebulizer with Reservoir Bag |
62.8% |
- FDM<4.7μm from Breath Actuated Jet Nebulizer was significantly higher than Jet Nebulizer and Jet Nebulizer with Reservoir Bag at every point.
- Breath Actuated Jet Nebulizer achieved similar drug delivery in half the time due to its breath actuation feature.
Conclusion:
All three nebulizers provided incremental dose delivery over time, with the Breath Actuated Jet Nebulizer demonstrating the highest fine droplet fraction and delivering medication more efficiently. Breath Actuated Jet Nebulizer also offered a time-saving advantage. Performance differences among devices highlight the importance of selecting the appropriate device for optimal drug delivery.
Am J Respir Crit Care Med 2025; 211: A4046
American Thoracic Society 2025 International Conference, May 18-21, San Francisco
