Comparison of two methods of delivering continuously nebulized albuterol.
OBJECTIVE
To compare the relative delivery of 2 methods for providing continuously nebulized albuterol (CNA): a small-volume nebulizer plus infusion pump versus a large-volume nebulizer.


METHODS
An open, randomized comparison of 3 hours of CNA administration using an in vitro lung model with a follow-up particle size assessment of the large-volume nebulizer.


METHODS
Six different nebulizers of each type were connected to a lung model via a volume-limited mechanical ventilator and infant ventilator circuitry. Albuterol was nebulized at 10 mg/h for 3 hours in random order. The small-volume nebulizer used was the Airlife Misty Neb (Baxter, Valencia, CA); the large-volume nebulizer was the HEART Nebulizer (Vortran Medical, Orangevale, CA). One large-volume nebulizer was operated over 8 hours for the output and particle sizing study.


RESULTS
The small-volume nebulizer delivered a greater amount of albuterol (mean +/- SD percentage of total nebulized) to the model lung (5.75 +/- 1.38% vs. 4.12 +/- 0.67%; p < 0.025) than the large-volume nebulizer, but demonstrated greater variability. Although total output was not maintained after 8 hours of nebulization with the large-volume nebulizer, the percent of particles in the respirable range remained consistent.


CONCLUSIONS
The large-volume nebulizer evaluated in this study maintains consistent output up to 8 hours and provides an acceptable method for delivering CNA through an infant ventilator circuit.
Kelly
H William
HW
Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM 87131-5311, USA. hwkelly@unm.edu
Keim
Kerry A
KA
McWilliams
Bennie C
BC
D000280:Administration, Inhalation; D000336:Aerosols; D000420:Albuterol / Q000008:administration & dosage*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D004867:Equipment Design; D006801:Humans; D007223:Infant; D007260:Infusion Pumps; D008961:Models, Structural; D009330:Nebulizers and Vaporizers; D012121:Respiration, Artificial
D000336:Aerosols; D001993:Bronchodilator Agents; D000420:Albuterol