Effect of driving pressure and nebulizer model on aerosol output during intermittent delivery with a dosimeter.
Recent guidelines reinforce the need for a standardized technique during inhalational bronchoprovocation challenge testing. We investigated the effects of nebulizer model and dosimeter driving pressure on nebulizer output using a nebulized saline model. Four nebulizers (Hudson 1720, Salter 8900, Baxter Airlife, and DeVilbiss 644) were evaluated at two driving pressures (20 and 50 pounds per square inch [psi]) via a dosimeter (Salter 700) that delivered a 0.6-sec actuation. Output was determined gravimetrically after 20 actuations of saline at constant respiratory flow and volume. Output per actuation at 20 psi was 2.83 +/- 0.41 mg (mean +/- SD), 4.58 +/- 0.66, 4.75 +/- 0.42, and 4.75 +/- 1.37 for the Hudson, Salter, Baxter, and DeVilbiss, respectively, and 6.75 +/- 0.61 mg, 9.17 +/- 0.88, 9.42 +/- 1.32, and 9.83 +/- 1.75 at 50 psi. The Hudson delivered a lower volume than the other nebulizers (p < 0.0005). At 20 psi, output from the DeVilbiss had greater variability (coefficient of variation = 28.8%) compared to the Baxter (CV = 8.8%; p = 0.045). The output was greater at 50 psi than 20 psi for all models (p < 0.0005). These results demonstrate that, when choosing a nebulizer driven by a dosimeter, it is important to base that selection on published data describing aerosol output under different driving pressures.
Alkins
Stephan A
SA
Pulmonary and Critical Care Medicine Service, Department of Internal Medicine, Walter Reed Army Medical Center, Washington, DC, USA. stephen.alkins@lnd.amedd.army.mil
Hurwitz
Kenneth M
KM
Sierra
Angel
A
D000336:Aerosols; D001985:Bronchial Provocation Tests / Q000295:instrumentation* / Q000592:standards; D004867:Equipment Design; D009330:Nebulizers and Vaporizers / Q000592:standards*; D011312:Pressure; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage; D014894:Weights and Measures
D000336:Aerosols; D012965:Sodium Chloride