[Comparative study of the performance and ergonomics of nebulizers in cystic fibrosis].
This study had, as its aim, to test twelve nebulizers (6 jet, 6 ultrasonic) which are used in the treatment of cystic fibrosis. Devices were connected to a respirator in order to mimic the ventilation of a child and of an adult suffering from cystis fibrosis. Three medications: tobramycine, colistine and amiloride were nebulised. The volume of the recommended solution varied between 1.5 and 13 ml according to the manufacturer. During a session of ten minutes the ultrasonic nebulizer delivered an inhaled volume which was significantly greater than the jet (2.72 +/- 0.98 ml vs 1.22 +/- 0.59 ml, p < 0.0001) for the three drugs. Regarding granulometry, the fraction of particles between 0.5 and 5 microns, was higher with ultrasonic than with pneumatic nebulizer for tobramycine (67.1 +/- 10.7 vs 55.5 +/- 11.5%, p < 0.001) and amiloride (66.4 +/- 9.2% vs 58.1 +/- 15%, p < 0.05%). The variation of concentration due to nebulisation were independent of the type of apparatus but influenced by the drug since concentration was increased for tobramycine (+10.5 +/- 18.6%) and amiloride (+13.4 +/- 8/9%). In summary the effective fraction resulting from the inhalable fraction, from granulometry and from changes in concentration was significantly greater for ultrasonic than for jet nebrulizer (17.3 +/- 6.7% vs 9.7 +/- 9.6%, p < 0.001). This study underlines the great variability of the performance of aerosols generators and therefore the need for an accurate evaluation of nebulizer performances in order to prescribe the best nebulizer/drug association in clinical practice.
Faurisson
F
F
INSERM U13, Paris.
Dessanges
J F
JF
Grimfeld
A
A
Beaulieu
R
R
Kitzis
M D
MD
Peytavin
G
G
Lefevre
J P
JP
Farinotti
R
R
Sautegeau
A
A
D000280:Administration, Inhalation; D000328:Adult; D000336:Aerosols / Q000008:administration & dosage; D000584:Amiloride / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002648:Child; D003091:Colistin / Q000008:administration & dosage; D003550:Cystic Fibrosis / Q000188:drug therapy*; D004232:Diuretics / Q000008:administration & dosage; D004867:Equipment Design; D006804:Ergonomics; D006801:Humans; D008422:Materials Testing; D009330:Nebulizers and Vaporizers / Q000592:standards*; D010316:Particle Size; D014031:Tobramycin / Q000008:administration & dosage
D000336:Aerosols; D000900:Anti-Bacterial Agents; D004232:Diuretics; D000584:Amiloride; D014031:Tobramycin; D003091:Colistin
Etude comparative sur les performances et l'ergonomie de nébuliseurs dans la mucoviscidose.