Delivered Dose Comparison between Breath-activated (Metered Dose and Non-metered Dose) and Breath-enhanced Nebulizers

R H M Hatley, S Byrne, B Woodington

In previous studies we have looked at the variability in dose between venturi jet, breath-enhanced, and mesh nebulizers. 1,2 In this study we extended the investigation to cover breath-activated nebulizers, comparing them to a representative breath-enhanced nebulizer. Here we report on a comparison of the delivered dose (DD) from the AeroEclipse II (AeroEclipse II; Monaghan Medical Corp.), a non-metered breath-activated nebulizer, the I-neb Adaptive Aerosol Delivery (AAD) System (Respironics Respiratory Drug Delivery (UK) Ltd), a metered breathactivated
nebulizer, and the LC Sprint (PARI GmbH), a breath-enhanced nebulizer. The I-neb AAD System and the AeroEclipse II nebulizer only deliver aerosol during inhalation, but the LC Sprint nebulizer also delivers during exhalation, albeit at a reduced rate. The breath-activated nebulizers claim greater reproducibility of DD. Each nebulizer was filled with 2.5 mL salbutamol sulphate (Salamol Steri-Neb, 2 mg/mL, IVAX Pharmaceuticals) and attached to an ASL 5000 breathing simulator (IngMar Medical Ltd) set to an adult breathing pattern (tidal volume = 500 mL, 10 breaths per minute, inhalation:exhalation ratio = 1:2). The AeroEclipse II nebulizer and the LC
Sprint nebulizer were driven by 6 L/min medical air and run until sputter plus 60 seconds. The I-neb AAD System was fitted with a 0.5 mL dosing chamber and run until the end of aerosol generation. Delivery period was recorded for all nebulizers. The results indicated that the breath-activated nebulizers allow for a more reproducible DD. The DD results from the 2 breath-activated nebulizers were significantly different, and a considerably greater DD was delivered from the AeroEclipse II nebulizer, compared to the LC Sprint nebulizer or the I-neb AAD System. If such differences in DD were replicated in vivo, they could be translated into clinically relevant differences in drug dose available to the patient.

Join today to view and download the full abstract/presentation