PURPOSE: The use of portable nebulizer systems has become more prevalent because of their convenient size and weight. However, no evidence exists to evaluate their efficacy. We compared four common portable nebulizer/compressor systems to compare efficacy in aerosol delivery.
METHODS: We compared the MiniElite and MicroElite (Philips/Respironics, Murrysville, PA), Traveler (DeVilbiss, Somerset, PA) and Trek S (Pari, Midlothian, VA) using 200 uL of radiolabelled T99 added to a 3 mL ampule of 2.5 mg albuterol (Nephron Pharmaceuticals Corporation, Orlando, FL). Particle size was measured by cascade impaction. Output characteristics were determined by measuring the T99 on an inspiratory filter and on a filter capturing flow from the nebulizer exhalation valve. A Harvard pump simulated breathing patterns using 500 ml, 15 breaths min, and 0.5 duty cycle. Nebulizers were timed until dry. Prior testing by cascade impaction confirmed homogeneity for co-location of T99 and albuterol. Respiratory dose (RD; ug) is the total drug delivered in the respirable range. Respiratory drug delivery rate (RDDR; ug/min) is the amount of drug delivered in the respiratory range per minute. Tests were performed in triplicate and analyzed with ANOVA using Tukey’s post hoc analysis with significance level set at 0.05. All tests were performed in the Center for Environmental Medicine, Asthma and Lung Biology laboratories at the University of North Carolina.
RESULTS: For RDDR there was no statistically signficant difference between Trek S and MiniElite but both were higher than the Traveler and MicroElite (p< 0.05). For the RD the Trek delivered higher doses than the other three (p< 0.01) and Traveler was the lowest (p< 0.05). There was no statistical difference between the MiniElite and MicroElite for RD.
CONCLUSION: There is over a 7 fold difference in RDDR and almost 4 fold difference in RD between the highest performing portable nebulizer system and the lowest.
CLINICAL IMPLICATIONS: Large differences between nebulizer/compressor system’s drug delivery may negatively influence the assessment of drug efficacy.
DISCLOSURE: Norman Tiffin, Employee Norman Tiffin is a former employee of Pari Respiratory Equipment within last 11 months.; Consultant fee, speaker bureau, advisory committee, etc. Norm Tiffin received consultant fees from Pari Respiratory Equipment. Co author Kirby Zeman performed work under contract from Pari Respiratory Equipment.; No Product/Research Disclosure Information