Abstract
BACKGROUND: Inhaled recombinant human DNase I (rhDNase) improves clearance of viscoelastic secretions in patients with cystic fibrosis. Because of their portability, newer-generation vibrating-mesh nebulizers offer greater convenience for the patient, but their efficiency in delivering rhDNase has not been determined.
METHODS: We compared a newer-generation vibratingmesh nebulizer (Omron MicroAir) to a Pari LC+ with the Pari ProNeb Ultra compressor (a commonly employed rhDNase administration system). With the Next Generation Pharmaceutical Impactor, we determined aerosol particle distribution. We also measured mass output efficiency, nebulization time, and mass of rhDNase that deposited on a filter during simulated breathing.
METHODS: The mass median aerodynamic diameter (MMAD) and geometric standard deviation (GSD) of aerosol from the MicroAir (MMAD 4.3 m, GSD 2.8 m) was equivalent to that from the Pari LC+ (MMAD 4.2 m, GSD 2.7 μm). During simulated breathing the MicroAir had a higher total mass output efficiency (88%) than the Pari LC+ (68%) (P < .001), and total nebulization time was shorter with the MicroAir (6.1 min vs 7.2 min, P = .03). When nebulized to dryness, the mass of rhDNase delivered to the filter was comparable with the MicroAir (1.30 ± 0.4 mg) and Pari LC+ (1.21 ± 0.05 mg).
CONCLUSIONS: The MicroAir could be employed as a portable nebulizer for rhDNase therapy in patients with cystic fibrosis.
Footnotes
- Correspondence: Rajiv Dhand MD FAARC, Division of Pulmonary, Critical Care, and Environmental Medicine, University of Missouri-Columbia, MA-421 Health Sciences Center, DC043.00, 1 Hospital Drive, Columbia MO 65212. Email: dhandr{at}health.missouri.edu.
This research was partly supported by Omron Healthcare (which provided the MicroAir nebulizers), the United States Veterans Affairs Research Service, the Department of Internal Medicine, University of Missouri, Columbia, and the Missouri Research Foundation. The device and drug manufacturers were not involved in designing the study, collecting, analyzing, or interpreting the data, or preparing the manuscript. The authors report no other conflicts of interest related to the content of this paper.
- Copyright © 2008 by Daedalus Enterprises Inc.