Chest
Clinical InvestigationsDisposable Jet Nebulizers: How Reliable Are They?
Section snippets
METHODS
In the first phase, we evaluated 12 units of each of the jet nebulizer models for visual signs of malfunction and for rate of nebulization (Table 1). After placing 3 ml of normal saline solution in each nebulizer, we weighed the nebulizer, and air flow through the nebulizer was set at a constant rate of 6 L/min. Every minute for the first 3 min of each trial, the nebulizer was weighed. Nebulization rates (expressed in milliliters per minute) were calculated from weight differences. Nebulization
RESULTS
In phase 1, four of the eight models tested showed visual signs of malfunction (Table 1). Model 8 had large, individually visible droplets spraying out the top of each of five units tested. Model 7 had air bubbling through the saline solution rather than being forced through the jet, such that nebulization did not occur at all in seven of the 11 nebulizers. Model 6 had saline solution leaking from a screw top joint in each of 12 units tested. Finally, model 4 functioned adequately if held at
DISCUSSION
These results indicate a deficiency of quality control or design on the part of some manufacturers in the disposable nebulizer industry. Half of the models tested showed such serious visual signs of malfunction that the rate of clinically useful aerosol output could not be determined. For the model with the largest unit-to-unit variability in rate of nebulization, particle size varied over a wide range and appeared to correlate with rate of nebulization. Unit-to-unit variability in this model
APPENDIX
Nebulizer units tested at the time experimental work in this study was performed may or may not be representative of those produced under current practices. WeEmpty Cell Nebulizer Models Investigated* Empty Cell Designation in Article Manufacturer Model No. 1 Baxter, Valencia, CA 00214 2 Puritan-Bennett, Overland Park, KS 001140 (Raindrop) 3 Intec Medical, Bluesprings, MO 2016 4 Intec Medical, Bluesprings, MO 3017 5 Hospitak, Lindenhurst, NY Up-Mist 6 Hudson, Temecula, CA Up-Draft II 7 Baxter, Valencia, CA 008120 8 AVA Corporation † AVA-neb
REFERENCES (17)
- et al.
Comparison of outpatient nebulized vs metered dose inhaler terbutaline in chronic airflow obstruction
Chest
(1989) - et al.
Aerosolized terbutaline in asthmatics
J Allergy Clin Immunol
(1979) Aerosol therapy in acute and chronic respiratory disease
Arch Intern Med
(1973)Principles of nebulizer-delivered drug therapy for asthma
Am J Hosp Pharm
(1989)- et al.
Aerosol carbenicillin and gentamicin treatment of Pseudomonas aeruginosa infection in patients with cystic fibrosis
Lancet
(1981) - et al.
Long-term tobramycin aerosol therapy in cystic fibrosis
Pediatr Pulmonol
(1989) Acceleration and curvilinear particle motion
Particle size statistics
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