Comparative Scintigraphic Assessment of Deposition of Radiolabeled Albuterol Delivered From a Breath Actuated Nebulizer and a Small Volume Jet Nebulizer to Healthy Subjects

Abstract

Background: Medication nebulizers are commonly used to delivery aerosolized medications to patients with respiratory disease. To compare in vivo aerosol delivery characteristics of a breath-actuated nebulizer (BAN) to that of a standard small volume jet nebulizer (SVN) we evaluated output and regional lung deposition of indirectly radiolabeled albuterol. Methods: Eight healthy subjects received albuterol (2.5 mg/3 mL) admixed with 2 mCi of Tc-DTPA (Technetium-99m bound to diethylenetriaminepentaacetic acid) administered using both the BAN (Aeroeclipse II) and SVN (Nebutech HD). Regional doses were then determined from anterior and posterior gamma camera images collected after delivery. Lung perimeters were defined using Cobalt-57 transmission scans and applied to Tc-DTPA deposition images. The study was approved by the University of Pittsburgh Institutional Review Board. Results: Average age of the 8 subjects (4 male, 4 female) was 33 years. The dose deposited in each subject, on average, was 1.03 ± 0.14 mg vs 0.89 ± 0.15 mg for the BAN and SVN respectively. The dose deposited in each subject regionally quantified into the following regions and averages were expressed as percentage of deposited dose (%) ± one standard deviation. Conclusions: The BAN (75.0%) demonstrated increased aerosol deposition to the lungs in healthy subjects as compared to the SVN (46.8%) (P < .006). Further studies in patients are needed to confirm the clinical benefit of this increased lung deposition. In vivo deposition patterns also demonstrated that the SVN delivered significantly more aerosol to the upper respiratory tract as indicated by deposition found in both the stomach and tracheo-esophageal regions (P < .005). Disclosures: This study was funded by Monaghan Medical Corporation.