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Research ArticleOriginal Research

Inadequate Functioning of Nebulizer System Compressors Used by Individuals With Cystic Fibrosis

Evanirso S Aquino, Alberto A Vergara and Luiz Vicente R F Silva Filho
Respiratory Care May 2021, 66 (5) 829-836; DOI: https://doi.org/10.4187/respcare.07702
Evanirso S Aquino
Instituto de Medicina Tropical, University of São Paulo, São Paulo, Brazil.
João Paulo II Pediatric Hospital, Fundação Hospital of the State of Minas Gerais, Belo Horizonte, Brazil.
Pontifical Catholic University of Minas Gerais, Betim Campus, Belo Horizonte, Brazil.
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Alberto A Vergara
João Paulo II Pediatric Hospital, Fundação Hospital of the State of Minas Gerais, Belo Horizonte, Brazil.
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Luiz Vicente R F Silva Filho
Instituto de Medicina Tropical, University of São Paulo, São Paulo, Brazil.
Instituto da Criança, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
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Abstract

BACKGROUND: The treatment of cystic fibrosis involves the use of drugs delivered by nebulizer systems, and adequate functioning of the compressors and nebulizers is essential. We hypothesized that compressors of nebulizer systems used by individuals with cystic fibrosis would not work properly. Therefore, we aimed to assess the performance of the compressors from nebulizer systems used by individuals with cystic fibrosis.

METHODS: This is a cross-sectional study to assess the performance of compressors from nebulizer systems used by subjects with cystic fibrosis registered at the Cystic Fibrosis Patient Association in Minas Gerais, Brazil. Compressors (Proneb Ultra II) brought by the individuals were tested with new nebulizer parts (Pari LC plus) to assess the variables of nebulization efficiency, including residual volume, solution output, and aerosol output rate. Compression performance was assessed by measuring the operating pressure using a PARI PG101 manometer.

RESULTS: The performance of 146 compressors was analyzed. Fifty-seven (39%) of the compressors were ineffective, with operating pressure values well below the manufacturer's technical reference and the compressor time used for a median time of 36 (15 days to 156 months). The systems with low pressure values demonstrated significantly worse results for nebulization efficiency variables, and a significant correlation was found between residual volume (r = –0.5, P < .001), solution output (r = +0.5, P < .001), and aerosol output rate (r = +0.5, P < .001), and operating pressure values.

CONCLUSIONS: A significant number of compressors generate low operating pressure values. These systems showed a compromised efficiency of nebulization, indicating that the pressure generated by the compressor is a critical aspect of treatment efficiency.

  • cystic fibrosis
  • jet nebulizer
  • compressor
  • nebulizer delivered volume
  • residual volume
  • aerosol therapy
  • nebulizer operating pressure

Footnotes

  • Correspondence: Evanirso S Aquino PT PhD, João Paulo II Pediatric Hospital, Fundação Hospital of the State of Minas Gerais, Alameda Ezequiel Dias, 345, Centro, Belo Horizonte MG, 30130-110, Brazil. E-mail: evanirso-aquino{at}uol.com.br
  • Dr Aquino presented a version of this paper at the Institute of Tropical Medicine of the University of São Paulo on October 05, 2018.

    This work was supported by a grant from Novartis Ph armaceuticals. Dr Aquino has disclosed relationships with Vertex Pharmaceuticals and Roche do Brasil. Dr Silva Filho has disclosed relationships with Vertex Pharmaceuticals, Timpel, Diagnostics of America, Roche do Brasil, Boehringer Ingelheim, Glenmark do Brasil, AbbVie, and Sanofi. Dr Vergara has disclosed relationships with Vertex Pharmaceuticals and Roche do Brasil.

  • Supplementary material related to this paper is available at http://www.rcjournal.com.

  • Copyright © 2021 by Daedalus Enterprises
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Respiratory Care: 66 (5)
Respiratory Care
Vol. 66, Issue 5
1 May 2021
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Inadequate Functioning of Nebulizer System Compressors Used by Individuals With Cystic Fibrosis
Evanirso S Aquino, Alberto A Vergara, Luiz Vicente R F Silva Filho
Respiratory Care May 2021, 66 (5) 829-836; DOI: 10.4187/respcare.07702

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Inadequate Functioning of Nebulizer System Compressors Used by Individuals With Cystic Fibrosis
Evanirso S Aquino, Alberto A Vergara, Luiz Vicente R F Silva Filho
Respiratory Care May 2021, 66 (5) 829-836; DOI: 10.4187/respcare.07702
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Keywords

  • cystic fibrosis
  • jet nebulizer
  • compressor
  • nebulizer delivered volume
  • residual volume
  • aerosol therapy
  • nebulizer operating pressure

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