Chest
Clinical InvestigationsAEROSOLSComparison of Lung Deposition in Two Types of Nebulization: Intrapulmonary Percussive Ventilation vs Jet Nebulization
Section snippets
Subjects
Ten healthy men, all nonsmokers (mean age, 28 years; range, 23 to 43 years), were investigated. All subjects underwent standard spirometry according to American Thoracic Society guidelines.12 The Ethics Committee of our institution approved the study, and a written, informed consent was obtained from the volunteers.
Nebulizers
Both devices were driven by the same pressure: 3.5 bars of compressed air. For standard jet nebulization (SST), we chose a well-studied nebulizer (SideStream; Medic-Aid; West Sussex,
Lung Function Tests
Table 1 presents average anthropometric and lung function data of the subjects. All volunteers had spirometric values in the normal range.
Aerodynamic Particle Size Analysis
The FPFs were 67.5% and 16.2% for SST and IPV, respectively. The EDs were 13.4% and 1.45% for SST and for IPV, respectively. MMADs were 1.89 μm for SST and 0.2 μm for IPV. Output flow of the nebulizers was 10.3 L/min for SST and 70.6 L/min for IPV.
Pattern of Breathing During Nebulization
Table 2 summarizes the data of ventilation. Average RF was significantly lower with IPV than with SST. Average Vt
Discussion
We have found that nebulization combined with IPV resulted in a higher WBD than SST. This was due to a higher extrapulmonary deposition with the IPV. This device delivered intrapulmonary aerosols irregularly in a group of naive healthy subjects.
Although in vitro testings present some limitations and may give an overestimation of the lung deposition measured in vivo,17 it remains nevertheless an acceptable way to compare two methods in a standardized protocol. FPF was small, and particle size
ACKNOWLEDGMENT
The authors thank R. Vanbever and C. Bosquillon for help in collecting and interpreting in vitro data.
References (25)
- et al.
Effect of size and disease on estimated deposition of drugs administered using jet nebulization in children with cystic fibrosis
Chest
(2001) - et al.
An assessment of jet and ultrasonic nebulisers for the delivery of lactate dehydrogenase solutions
Int J Pharm
(2001) - et al.
Comparison of intrapulmonary percussive ventilation and chest physiotherapy: a pilot study in patients with cystic fibrosis
Chest
(1994) - et al.
Assessing lung deposition of inhaled medications: consensus statement from a workshop of the British Association for Lung Research, held at the Institute of Biology, London, UK, on 17 April 1998
Respir Med
(1999) - et al.
A comparison of commercial jet nebulizers
Chest
(1994) - et al.
Aerosol penetration into the lung; influence on airway responses
Chest
(1981) - et al.
Drug properties affecting aerosol behavior
Respir Care
(2000) - et al.
In vitro characteristics of tobramycin aerosol from ultrasonic and jet nebulizers
Pharmacotherapy
(2001) - et al.
Etude comparative sur les performances et l'ergonomie de nebuliseurs dans la mucoviscidose. [Comparative study of the performance and ergonomics of nebulizers in cystic fibrosis]
Rev Mal Respir
(1996) Lung deposition from nebulizers
Eur Respir Rev
(2000)
Pulmonary deposition of nebulised amiloride in cystic fibrosis: comparison of two nebulisers
Thorax
Effectiveness of beclomethasone dipropionate aerosolized through different nebulizers to asthmatic patients
Eur Rev Med Pharmacol Sci
Cited by (40)
Airway clearance in patients with neuromuscular disease
2023, Paediatric Respiratory ReviewsRespiratory physiotherapy in pediatric practice
2022, Revue des Maladies RespiratoiresEfficacy of Oscillation and Lung Expansion in Reducing Postoperative Pulmonary Complication
2019, Journal of the American College of SurgeonsInhaled formulations and pulmonary drug delivery systems for respiratory infections
2015, Advanced Drug Delivery ReviewsCitation Excerpt :Recent advances in nebuliser design have been reviewed elsewhere [9]. Briefly, conventional jet nebulisers are bulky and generally have low drug delivery efficiencies [14], whilst vibrating mesh nebulisers exhibit minimal residual volume, rapid output and improved drug delivery efficiencies despite its higher purchase price. Other emerging technologies for nebulisation include surface acoustic wave microfluidic atomisation, which was shown to have a high delivery efficiency, with FPF ranging from 70–80% [15].
Complementary Home Mechanical Ventilation Techniques: SEPAR Year 2014
2014, Archivos de BronconeumologiaCitation Excerpt :Moreover, they act mechanically on the rheological properties of mucus.7,8 Other systems, such as intrapulmonary percussive ventilation9,10 or external high-frequency chest-wall oscillation/compression devices, have been used in airway clearance, helping to mobilize secretions and acting on mucus viscoelasticity.11 Although these techniques have few adverse effects, gas exchange alterations and respiratory failure have been described in both healthy subjects and in subjects with chronic obstructive pulmonary disease (COPD) exacerbations.12
Colistin powders with high aerosolisation efficiency for respiratory infection: Preparation and in vitro evaluation
2013, Journal of Pharmaceutical SciencesCitation Excerpt :However, nebulisation requires hospital or home setting device, well-trained professional oversight, long administration time and, more importantly, low drug delivery efficiency.10 For example, only less than 15% of total drug deposited in lungs after the nebulisation treatment in an in vivo study with intrapulmonary percussive ventilation or jet nebulisation.11 In contrast, dry powder inhalers (DPIs), which consist of drug (alone or with excipients) powder and inhaler device, are easier to carry and operate, which would lead to better patient compliance.
Partly supported by the Belgian “Fonds National de la Recherche Scientifique” grant No. 3.4536.98.