Abstract
The deposition efficiency of three methods of aerosol delivery of salbutamol into lungs of ventilated rabbits was compared: 1) metered dose inhaler (MDI) with holding chamber (HC), 2) jet nebulizer (JN), and 3) ultrasonic (US) nebulizer. The latter system was tested using two different sized medication reservoirs, a large (20 mL) cup (US20) and a small (10 mL) cup (US10). After delivery of technetium-99m-labeled sulbutamol aerosol, deposition in the lungs, trachea, and ventilator circuit were estimated by a γ counter. Total pulmonary deposition [mean(SEM)] as a percentage of the prescribed drug was: MDI + HC 0.22(0.05)%; JN 0.48(0.05)%; US20 0.90(0.13)%; US10 3.05(0.49%)%. Only the deposition from the US10 was statistically significantly higher than the other modes (p < 0.05). Dynamic scintigraphy showed that, among the nebulizers, the US10 continued to deliver medication for longer than either the JN or the US20. We conclude that the US10 appears to be more efficient in delivering aerosol to the lung in this rabbit model and merits further evaluation for clinical efficiency.
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Abbreviations
- MDI:
-
metered dose inhaler
- JN:
-
jet nebulizer
- US:
-
ultrasonic
- HSA:
-
human serum albumin
- MMAD:
-
mass median aerodynamic diamete
References
LaForce WR, Brudno DS 1993 Controlled trial of beclomethasone dipropionate by nebulization in oxygen- and ventilator-dependent infants. J Pediatr 122: 285–288.
Yuksel B, Greenough A, Maconochie I 1990 Effective bronchodilator treatment by a simple spacer device for wheezy premature infants. Arch Dis Child 65: 782–785.
Pfenninger J, Aebi C 1993 Respiratory response to salbutamol (albuterol) in ventilator-dependent infants with chronic lung disease: pressurized aerosol delivery versus intravenous injection. Intensive Care Med 19: 251–255.
Cabal LA, Larrazabal C, Ramanathan R, Durand M, Lewis D, Siassi B, Hodgman J 1987 Effects of metaproterenol on pulmonary mechanics, oxygenation, and ventilation in infants with chronic lung disease. J Pediatr 110: 116–119.
Wilkie RA, Bryan MH 1987 Effect of bronchodilators on airway resistance in ventilator-dependent neonates with chronic lung disease. J Pediatr 111: 278–282.
Rotschild A, Solimano A, Puterman M, Smyth J, Sharma A, Albersheim S 1989 Increased compliance in response to salbutamol in premature infants with developing bronchopulmonary dysplasia. J Pediatr 115: 984–991.
Denjean A, Guimaraes H, Migdal M, Miramand JL, Dehan M, Gaultier C 1992 Dose-related bronchodilator response to aerosolized salbutamol (albuterol) in ventilator-dependent premature infants. J Pediatr 120: 974–979.
Kraemer R, Birrer P, Modelska K, Casaulta Aebischer C, Schöni MH 1992 A new baby-spacer device for aerosolized bronchodilator administration in infants with bronchopulmonary disease. Eur J Pediatr 151: 57–60.
Kao LC, Warburton D, Platzker ACG, Keens TG 1984 Effect of isoproterenol inhalation on airway resistance in chronic bronchopulmonary dysplasia. Pediatrics 73: 509–514.
Arnon S, Grigg J, Nikander K, Silverman M 1992 Delivery of micronized budesonide suspension by metered dose inhaler and jet nebulizer into neonatal ventilator circuit. Pediatr Pulmonol 13: 172–175.
Cameron D, Arnot R, Clay M, Silverman M 1991 Aerosol delivery in neonatal ventilator circuits: a rabbit lung model. Pediatr Pulmonol 10: 208–213.
Watterberg KL, Clark AR, Kelly HW, Murphy S 1991 Delivery of aerosolized medication to intubated babies. Pediatr Pulmonol 10: 136–141.
Cameron D, Clay M, Silverman M 1990 Evaluation of nebulizers for use in neonatal ventilator circuits. Crit Care Med 18: 866–870.
Flavin M, MacDonald M, Dolovich M, Coates G, O'Brodovich H 1986 Aerosol delivery to the rabbit lung with an infant ventilator. Pediatr Pulmonol 2: 35–39.
Grigg J, Arnon S, Jones T, Clarke A, Silverman M 1992 Delivery of therapeutic aerosols to intubated infants. Arch Dis Child 67: 25–30.
Fuller HD, Dolovich M, Chambers C, Newhouse MT 1992 Aerosol delivery during mechanical ventilation: a predictive in vivo lung model. J Aerosol Med 5: 251–259.
Summer QA, Hollingsworth A, Clark AR, Fleming J, Holgate ST 1990 The preparation of a radiolabelled aerosol of nedocromil sodium for administration by metered-dose inhaler that accurately preserves particle size distribution of the drug. Drug Invest 2: 90–98.
Manthouss CA, Hall JB, Schmidt GA, Wood LDH 1993 Metered-dose inhaler versus nebulized albuterol in mechanically ventilated patients. Am Rev Respir Dis 148: 1567–70.
Dolovich M, Mitchell JP, Nagel MW 1995 Comparison of performance of aluminum with plastic holding chambers with four drugs used in inhalation therapy. Eur Respir J 8( suppl 19): 201s.
Fok TF, Monkman S, Dolovich M, Gray S, Coates G, Paes B, Rashid F, Newhouse M, Kirpalani H 1996 Efficiency of aerosol medication delivery from a metered dose inhaler versus jet nebulizer in infants with bronchopulmonary dysplasia. Ped Pulmonol 21: 301–309.
O'Callaghan C, Hardy J, Stammers J, Stephenson TJ, Hull D 1992 Evaluation of techniques for delivery of steroids to lungs of neonates using a rabbit model. Arch Dis Child 67: 20–24.
Rozycki HJ, Bryon PR, Dailey K, Gutcher GR 1991 Evaluation of a system for the delivery of inhaled beclomethasone dipropionate to intubated neonates. Dev Pharmacol Ther 16: 65–70.
Everard ML, Stammers J, Hardy JG, Milner AD 1992 New aerosol delivery system for neonatal ventilator circuits. Arch Dis Child 67: 826–830.
Madsen F, Nielsen NH, Frølund L, Svendsen VG, Weeke B 1987 Bronchial challenge: a small reservoir for the wright jet nebulizer. Bull Eur Physiol Pathol Respir 23: 67–71.
O'Doherty MJ, Thomas SML, Page CJ, Treacher DF, Nunan TO 1992 Delivery of a nebulized aerosol to a lung model during mechanical ventilation. Am Rev Respir Dis 146: 383–388.
Dolovich MB, Sanchis J, Rossman C, Newhouse MT 1976 Aerosol penetrance: a sensitive index of peripheral airway obstruction. J Appl Physiol 40: 468–471.
Acknowledgements
The authors thank Siemens Canada and Siemens Elema AB, Sweden, who provided us with the US nebulizers, and Pat Haslett and Sheryl Fisker for their excellent secretarial help.
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Fok, TF., Al-Essa, M., Monkman, S. et al. Pulmonary Deposition of Salbutamol Aerosol Delivered by Metered Dose Inhaler, Jet Nebulizer, and Ultrasonic Nebulizer in Mechanically Ventilated Rabbits. Pediatr Res 42, 721–727 (1997). https://doi.org/10.1203/00006450-199711000-00027
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DOI: https://doi.org/10.1203/00006450-199711000-00027
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