title: Four hours of continuous albuterol nebulization.
abstract: OBJECTIVE
  Continuous albuterol nebulization (CAN) is a therapeutic modality available to treat status asthmaticus. Currently, CAN may be administered using a large-volume nebulizer (LVN) or a small-volume nebulizer attached to an infusion pump or refilled as needed. Few data are available regarding the reproducibility of aerosol characteristics during CAN. In this study, we determined the aerodynamic profile, drug output (DO), DO in respirable range (RD), solution output (SO), and changes in reservoir's albuterol concentration (AR) hourly during 4 hours of CAN.
  
  
  METHODS
  A modified Puritan-Bennett 1600 jet nebulizer was tested with a large reservoir (LR; 250 mL), medium reservoir (MR; 45 mL), and small reservoir with infusion pump (SRP; 18 mL). We used 100-, 40-, and 4-mL initial fill volumes (with 10-mL/h infusion for SRP) of 1 mg/mL albuterol solution for the LR, MR, and SRP, respectively. Particle size distribution and DO consistency were determined by impaction and spectrophotometric analysis (275 nm). We also determined albuterol mass output. The SO was determined by gravimetric technique.
  
  
  RESULTS
  The PBsj produced a heterodisperse aerosol with a median mass aerodynamic diameter range of 1.8 to 2.2 microm. DO and RD paralleled SO. The LR had the highest SO, DO, and RD (8.03+/-2.36 vs 5.73+/-2.48 and 5.85+/-0.51 mg/h for MR and SRP, respectively). The AR showed no statistically significant changes.
  
  
  CONCLUSIONS
  The PBsj demonstrated consistent and adequate aerosol production during 4 hours of CAN. These bench data support the widespread use of a LVN for CAN.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: A
authors.initials: A
authors.lastname: Berlinski
authors.forename: J C
authors.initials: JC
authors.lastname: Waldrep
mesh_terms: D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D000420:Albuterol / Q000008:administration & dosage*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D009330:Nebulizers and Vaporizers; D010316:Particle Size; D013997:Time Factors
chemical_list: D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents; D000420:Albuterol