Abstract
BACKGROUND: Compressor/nebulizer units are used to deliver inhaled medications to patients with cystic fibrosis. Practitioners and parents frequently replace either the compressor or the nebulizer with a similar component from a different brand. We hypothesized that these changes could affect the compressor/nebulizer flow-pressure and aerosol characteristics.
METHODS: The following compressors were studied: Pari Vios, Pulmo-Aide model 5650D, and Inspiration Elite model HS456. The following nebulizers were studied: Pari LC Plus, Viox, and SideStream Plus. Units that underwent intense use were tested. The recommended compressor/nebulizer combinations by the manufacturers were compared to all other combinations. In-line measurements of maximal flow and pressure were done for all combinations. A Next Generation Impactor was used to determine particle-size characteristics of albuterol (2.5 mg/3 mL). A breathing simulator programmed to deliver an adult breathing pattern was used. Albuterol concentration was measured with spectrophotometry at 276 nm. The following variables were studied: maximal flow and pressure generated by the compressor/nebulizer, mass median aerodynamic diameter, percentage of drug mass contained in particles < 5 μm, and inhaled mass in the respirable range.
RESULTS: Replacing the nebulizer resulted in changes in the flow-pressure characteristics, particle size, and inhaled mass in the respirable range of the paired compressor/nebulizers. The changes were more pronounced when the nebulizer was replaced than when the compressor was changed.
CONCLUSIONS: Our findings indicate that, in general, replacing the nebulizer or compressor with a different brand changes the flow-pressure and aerosol characteristics. Practitioners should be cautious when changing compressor/nebulizer pairs unless they are aware of the resulting impact on the flow-pressure and aerosol characteristics.
Footnotes
- Correspondence: Samah M Awad MBBS, Department of Pediatrics and Neonatology, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan, King Abdullah University Hospital. E-mail: smawad{at}just.edu.jo.
Dr Awad presented a version of this paper as an abstract at the American Thoracic Society International Meeting, held May 16-21, 2014, in San Diego, California.
Dr Berlinski discloses relationships with AbbVie, Anthera, Aptalis Pharma, Cempra, Janssen Research and Development, Gilead, National Institutes of Health, Novartis, Therapeutic Development Network, Vertex, and the International Pharmaceutical Aerosol Consortium on Regulation and Science. Dr Awad has disclosed no conflicts of interest. This study was supported in part by the University of Arkansas for Medical Sciences College of Medicine Children's University Medical Group Fund grant program (#036135). The Pediatric Aerosol Research Laboratory at Arkansas Children's Hospital Research Institute was partially established by and receives partial support from the George Endowment for Asthma.
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