title: Aerosol delivery to the lung is more efficient using an extension with a standard jet nebulizer than an open-vent jet nebulizer.
abstract: BACKGROUND
  Open-vent jet nebulizers are frequently used to promote drug deposition in the lung, but their clinical efficacy and indications are not clear. Our study compared lung deposition of amikacin using two different configurations of a jet nebulizer (Sidestream(®)): one vented (N1) and one unvented with a corrugated piece of tubing (N2).
  
  
  METHODS
  In vitro nebulizer performance was assessed by laser diffraction and filtering. Lung delivery was evaluated by scintigraphy in baboons as a child model, and by amikacin urinary drug concentration in seven healthy spontaneously breathing volunteers. Subjects were randomly assigned to the two nebulizer systems (N1 and N2).
  
  
  CONCLUSIONS
  In vitro results showed a higher efficiency of N2 than N1 in terms of lung deposition prediction (95±3 mg vs. 70±0 mg; p<0.0001). Radioactivity deposition in the baboons' lungs was lower with N1 than with N2 (1.8% vs. 4.7% of nebulizer charge; p<0.05). The total daily amount of amikacin urinary excretion was lower with N1 than with N2 (29.5 mg vs. 40.1 mg; p<0.01). Conversely, in vivo drug output rate was higher with N1 than with N2 (3.1 mg/min vs. 2.2 mg/min; p<0.05). Using a corrugated piece of tubing with standard jet nebulizers delivers higher doses to the lungs than open-vent jet nebulizers. The open-vent jet nebulizer might be recommended for rapid administration of a lower dose to the lungs and the standard jet nebulizer with corrugated piece of tubing for a higher dose in the lungs.
authors.affiliation: Oral and Maxillofacial Surgery Unit, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium. Laurent.pitance@uclouvain.be
authors.forename: L
authors.initials: L
authors.lastname: Pitance
authors.forename: G
authors.initials: G
authors.lastname: Reychler
authors.forename: T
authors.initials: T
authors.lastname: Leal
authors.forename: H
authors.initials: H
authors.lastname: Reychler
authors.forename: G
authors.initials: G
authors.lastname: Liistro
authors.forename: J
authors.initials: J
authors.lastname: Montharu
authors.forename: Tech
authors.initials: T
authors.lastname: Lab
authors.forename: P
authors.initials: P
authors.lastname: Diot
authors.forename: L
authors.initials: L
authors.lastname: Vecellio
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000336:Aerosols; D000583:Amikacin / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000652:urine; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000652:urine; D016503:Drug Delivery Systems / Q000295:instrumentation*; D004867:Equipment Design; D006207:Half-Life; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000378:metabolism; D008297:Male; D008657:Metabolic Clearance Rate; D023421:Models, Animal; D009330:Nebulizers and Vaporizers; D010215:Papio; D011877:Radionuclide Imaging; D055815:Young Adult
chemical_list: D000336:Aerosols; D000900:Anti-Bacterial Agents; D000583:Amikacin