title: Reliability of Vibrating Mesh Technology.
abstract: BACKGROUND
  For delivery of inhaled aerosols, vibrating mesh systems are more efficient than jet nebulizers are and do not require added gas flow. We assessed the reliability of a vibrating mesh nebulizer (Aerogen Solo, Aerogen Ltd, Galway Ireland) suitable for use in mechanical ventilation.
  
  
  METHODS
  An initial observational study was performed with 6 nebulizers to determine run time and efficiency using normal saline and distilled water. Nebulizers were run until cessation of aerosol production was noted, with residual volume and run time recorded. Three controllers were used to assess the impact of the controller on nebulizer function. Following the observational study, a more detailed experimental protocol was performed using 20 nebulizers. For this analysis, 2 controllers were used, and time to cessation of aerosol production was noted. Gravimetric techniques were used to measure residual volume. Total nebulization time and residual volume were recorded. Failure was defined as premature cessation of aerosol production represented by residual volume of > 10% of the nebulizer charge.
  
  
  RESULTS
  In the initial observational protocol, an unexpected sporadic failure rate was noted of 25% in 55 experimental runs. In the experimental protocol, a failure rate was noted of 30% in 40 experimental runs. Failed runs in the experimental protocol exhibited a wide range of retained volume averaging ± SD 36 ± 21.3% compared with 3.2 ± 1.5% (P = .001) in successful runs. Small but significant differences existed in nebulization time between controllers.
  
  
  CONCLUSIONS
  Aerogen Solo nebulization was often randomly interrupted with a wide range of retained volumes.
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, State University of New York at Stony Brook, Stony Brook, New York ashwin.gowda@stonybrook.edu.
authors.forename: Ashwin A
authors.initials: AA
authors.lastname: Gowda
authors.affiliation: Respiratory Care Program, School of Health, Technology and Management, State University of New York at Stony Brook, Stony Brook, New York. Departmental funds were used to support this study. The authors have disclosed no conflicts of interest.
authors.forename: Ann D
authors.initials: AD
authors.lastname: Cuccia
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, State University of New York at Stony Brook, Stony Brook, New York.
authors.forename: Gerald C
authors.initials: GC
authors.lastname: Smaldone
mesh_terms: D000336:Aerosols; D004868:Equipment Failure; D009330:Nebulizers and Vaporizers / Q000592:standards*; D012121:Respiration, Artificial; D012965:Sodium Chloride; D013997:Time Factors; D014732:Vibration; D014867:Water
chemical_list: D000336:Aerosols; D014867:Water; D012965:Sodium Chloride
keywords: aerosol; efficiency; mechanical ventilation; nebulizer; residual volume; run time