title: A prospective, comparative trial of standard and breath-actuated nebulizer: efficacy, safety, and satisfaction.
abstract: BACKGROUND
  Nebulized drug delivery is a cornerstone of therapy for obstructive lung disease, but the ideal nebulizer design is uncertain. The breath-actuated nebulizer (BAN) may be superior to conventional nebulizers. This study compared the BAN to standard nebulizer with regard to  efficacy, safety, and patient and respiratory therapist (RT) satisfaction.
  
  
  METHODS
  Adults admitted to the hospital and for whom nebulizer therapy was prescribed were enrolled. Subjects were randomly assigned to either AeroEclipse II or standard nebulizer and were surveyed at the completion  of each treatment. BAN delivered albuterol 2.5 mg or albuterol 2.5 mg plus ipratropium 0.25 mg. Standard nebulizer delivered albuterol 2.5 mg or albuterol plus ipratropium 0.5 mg. An RT assessed each subject's heart rate, respiratory rate, and peak expiratory flow rate prior to and following  treatment. Treatment time and adverse events were recorded. Each RT was asked to assess his/her satisfaction with each of the nebulizers.
  
  
  RESULTS
  Twenty-eight subjects were studied. The mean age was 69 years. Fifty-four percent of the subjects indicated that overall the BAN was superior to  conventional nebulizer therapy; 68% indicated that duration was preferable with the BAN. RTs were more satisfied with the BAN, based on overall performance, treatment duration, and ease of use. There were no significant differences in heart rate, peak expiratory flow rate, or respiratory rate  before or after nebulization therapy with either device. The duration of treatment was significantly lower with the BAN (4.1 min vs 9.9 min, P < .001). Additionally, the BAN was associated with a lower occurrence of adverse events.
  
  
  CONCLUSIONS
  Patients and RTs expressed greater  satisfaction with the BAN, compared with standard nebulizer. Pre- and post-treatment vital signs did not differ between groups, but use of the BAN was associated with a shorter duration and a lower occurrence of adverse events. Taken together, these data support the use of the BAN for nebulized  medication delivery.
authors.affiliation: Division of Pulmonary Medicine, Mayo Clinic, Jacksonville, Florida, USA. arunthari.vichaya@mayo.edu
authors.forename: Vichaya
authors.initials: V
authors.lastname: Arunthari
authors.forename: Rikki S
authors.initials: RS
authors.lastname: Bruinsma
authors.forename: Augustine S
authors.initials: AS
authors.lastname: Lee
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Johnson
mesh_terms: D000280:Administration, Inhalation; D000368:Aged; D000420:Albuterol / Q000008:administration & dosage* / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D018592:Cross-Over Studies; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D009241:Ipratropium / Q000008:administration & dosage* / Q000627:therapeutic use; D008173:Lung Diseases, Obstructive / Q000188:drug therapy*; D008297:Male; D009330:Nebulizers and Vaporizers; D061214:Patient Safety; D017060:Patient Satisfaction; D010865:Pilot Projects; D011446:Prospective Studies; D012129:Respiratory Function Tests; D018709:Statistics, Nonparametric
chemical_list: D001993:Bronchodilator Agents; D009241:Ipratropium; D000420:Albuterol