SEARCH · PubMed Health

Results for “nebulization”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources

PubMed1996

Nebulized nitric oxide/nucleophile adduct reduces chronic pulmonary hypertension.

OBJECTIVE: Inhaled nitric oxide (NO) is a selective pulmonary vasodilator, but its use has been restricted almost exclusively to the intensive care setting due to the complexity of its delivery. NO/nucleophile adducts, such as diethylenetriamine/NO (DETA/NO), spontaneously release NO in aqueous solutions. We hypothesized that a nebulized DETA/NO (half-time of NO release > 20 h) would stay in the lower airways and continuously supply sufficient NO to achieve sustained vasodilation in chronic pulmonary hypertension. METHODS: Chronic pulmonary hypertension was induced in rats by a monocrotaline injection. Nineteen days later, nebulizations of DETA/NO were given on 4 consecutive days (5 and 50 mu mol; 10 min/day). One day after the last nebulization, pulmonary and systemic arterial pressure and cardiac output were measured after thoracotomy. The lungs were isolated and perfused to study the pressure-flow relationship. The effect of DETA/NO nebulization on acute vasoconstrictor reactivity was studied in additional isolated lungs. RESULTS: Total pulmonary, but not systemic, vascular resistance was significantly reduced by both DETA/NO doses, suggesting that DETA/NO, like NO, causes preferential dilation of the pulmonary circulation. The pulmonary perfusion pressure-flow curves were shifted downwards by DETA/NO treatment, indicating improved resistive properties of the pulmonary vasculature. DETA/NO nebulization into isolated lungs increased exhaled NO levels and progressively reduced vasoconstrictor responses to angiotensin II and acute hypoxia. These effects were not reversed by perfusate exchange. In intact rats, carotid artery pressure and plasma NO2- + NO3- levels did not change during and after DETA/NO nebulization. CONCLUSION: DETA/NO nebulization offers a possibility of once a day, ambulatory delivery of NO and is a potential treatment for chronic pulmonary hypertension, although further studies are needed to establish safety and selectivity.

Aerosols↗

PubMed1996

Effects of nebulized beta 2-adrenergic agonists on pulmonary mechanics in anesthetized patients with chronic obstructive pulmonary disease.

We evaluated the effects of nebulized beta 2-adrenergic agonists on pulmonary mechanics in patients with COPD undergoing peripheral surgery with a standardized general anesthetic technique. Thirty males with COPD were randomized into one of three groups. Group I (control group; n = 10) received nebulized saline 3 ml, Group II (n = 10) received nebulized albuterol (2.5 mg in 3 ml), and Group III (n = 10) received nebulized metaproterenol (15 mg in 3 ml). At 20 min after tracheal intubation, the study drugs were nebulized over 20 min. Datex Capnomac Ultima monitor was used to measure pulmonary mechanics on a breath-by-breath basis. There was no difference between the three groups with respect to demographic data and preoperative respiratory parameters. A similar degree of DPH occurred with the initiation of mechanical ventilation in all three groups. Patients receiving nebulized bronchodilators (Groups II and III) displayed a significant decrease in DPH and an increase in total dynamic compliance. However, there were no differences in DPH and total dynamic compliance between Groups II and III. We conclude that nebulization of either albuterol or metaproterenol can alleviate DPH resulting from mechanical ventilation in anesthetized patients with COPD.

Administration, Intranasal↗

PubMed2006

Effectiveness of nebulizer use-targeted asthma education on underserved children with asthma.

OBJECTIVE: To determine the effectiveness of a home-based asthma education intervention in increasing appropriate nebulizer use and reducing symptom frequency, emergency department (ED) visits, and hospitalizations over 12 months. DESIGN: A randomized clinical trial. Settings Pediatric primary care, pulmonary/allergy, and ED practices associated with the University of Maryland Medical System and The Johns Hopkins Hospital, Baltimore. PARTICIPANTS: Children with persistent asthma, aged 2 to 9 years, with regular nebulizer use and an ED visit or hospitalization within the past 12 months. Children were randomized into the intervention (n = 110) or control (n = 111) group. Follow-up data were available for 95 intervention and 86 control children. INTERVENTION: Home-based asthma education, including symptom recognition, home treatment of acute symptoms, appropriate asthma medication, and nebulizer practice. MAIN OUTCOME MEASURES: Estimates of mean differences in asthma symptom frequency, number of ED visits and hospitalizations and appropriate quick relief, controller medication, and nebulizer practice over 12 months. RESULTS: Of the 221 children, 181 (81.9%) completed the study. There were no significant differences in home nebulizer practice, asthma morbidity, ED visits, or hospitalizations between groups (P range, .11-.79). Although most children received appropriate nonurgent asthma care (mean, 2 visits per 6 months), more than one third of all children received at least 6 quick-relief medication prescriptions during 12 months, with no difference by group. CONCLUSIONS: A nebulizer education intervention had no effect on asthma severity or health care use. Of concern is the high quick-relief and low controller medication use in young children with asthma seen nearly every 3 months for nonurgent care.

Asthma↗

PubMed1997

Dose titration of nebulized budesonide in young children.

We compared the clinical effect of the glucocorticoid budesonide delivered from two nebulizers Aiolos and Pari LL in 38 children less than 4 years of age (mean age, 20.2 months) with chronic wheeze. The design was a controlled, single-blind, randomized, cross-over, dose titration study. After a 1-week run-in, patients were randomized to treatment with 1 mg budesonide b.i.d. for 2 weeks from either an Aiolos or a Pari LL nebulizer. This was followed by a gradual dose reduction period during which the budesonide dose was reduced at 2-week intervals until unacceptable asthma symptoms appeared or the placebo level was reached. The patient was then switched to budesonide 1 mg b.i.d. from the other nebulizer for 2 weeks, after which the dose was reduced at 2-week intervals as described for the first period. Patients who completed the study on placebo for 2 weeks without deterioration of their asthma were not included in the statistical analysis. During Period #1 the minimum effective dose of budesonide was 2 mg/day in 9 patients, 1 mg/day in 10 patients, and 0.5 mg/day in 13 patients. In Period #2 the corresponding figures were 14, 5, and 13 patients. Six patients were excluded after the first period because their asthma control did not deteriorate during dose reduction and when finishing on placebo for 2 weeks. For both nebulizers the reduction in budesonide dose was associated with a small increase in symptoms and use of rescue terbutaline. The mean dose of budesonide delivered to the patient by the Aiolos was twice as large as that delivered by the Pari LL: 26% vs. 13% of the nominal dose assessed by the filter method. Nevertheless, no statistically significant difference in clinical effect or mean minimal effective dose (1.1 mg for Aiolos and 1.2 mg for Pari LL) could be detected between the two nebulizers. No serious adverse events were observed. We conclude that the minimal effective dose of nebulized budesonide varies from 0.5 to 2.0 mg/day in young children with asthma. A higher drug delivery, as assessed by the filter method, does not necessarily result in better clinical control or lower minimal effective dose. Further studies are needed to assess whether this is due to insufficient sensitivity of the study design in detecting a difference in clinical effect, or whether measurements of drug delivery by the filter method do not reflect lung deposition or clinical effect in young children with wheezing.

Asthma↗

PubMed1994

Prediction and experimental determination of solute output from a Collison nebulizer.

The total output from a nebulizer is made up of aqueous droplets containing solute and a significant component of water vapor. The solvent loss is reflected in an increase in the nebulizer solution concentration over time and this has been described mathematically. This theory, originally described by Mercer et al., was modified to describe the solute output from a three-jet Collison nebulizer. The influence of concentration, air flow (air pressure), volume, and temperature on the output parameters were then studied. Inlet air pressures were 10 (4.1), 20 (6.4), and 40 (10.0) psig (L/min), starting concentrations were 0.1, 2, and 5% (w/w) and initial solution volumes were 10 and 20 mL. To study temperature effects, solutions were nebulized at fixed temperatures ranging from 4 to 50 degrees C. This was achieved by water-jacketing the nebulizer flask. Test solutions consisted of mannitol and a fixed concentration of 11.1 micrograms/mL carboxyfluorescein. Nebulization was carried out for up to 30 min using dry, filtered air at ambient temperature. Total output was determined gravimetrically while solute output was determined by fluorimetry (495-nm excitation, 515-nm emission). Solution concentration changes were also monitored over time by fluorimetry. The results show that the solution and solvent output parameters are independent of concentration, volume, and air flow within the ranges studied but that solvent output, in particular, is highly dependent upon temperature.

Chemistry, Pharmaceutical↗

PubMed1995

Assessment and provision of home nebulizers for chronic obstructive pulmonary disease (COPD) in the Yorkshire region of the U.K.

A survey was undertaken to determine the current practice in the Yorkshire Health Region for the assessment and provision of home nebulizers for adults with chronic obstructive pulmonary disease (COPD). A detailed postal questionnaire on assessment methods was sent to each of the 22 consultant physicians in respiratory medicine. The 17 consultants who also organized the adult home nebulizer service for their health district were asked about the services offered and funding for the service. Replies were received from all consultants. All physicians use objective measurement for assessing patients for home nebulizer therapy, but there is a variable emphasis on laboratory studies, walking distance and home trials with peak flow measurements. The majority (86%) incorporate a home trial into their assessment. Many physicians also take into account subjective response to nebulized bronchodilators. There is considerable variation in the provision and funding of home nebulizer services. Those districts with a coordinated service appear to offer a more comprehensive service. A consensus on nebulizer provision, with recommendations for minimum levels of provision in each health district, should result in a more uniform delivery of service.

Adult↗

PubMed2004

Nebulized lidocaine decreases the discomfort of nasogastric tube insertion: a randomized, double-blind trial.

STUDY OBJECTIVE: Nasogastric tube insertion is a common emergency department (ED) procedure that is associated with considerable patient discomfort. The safety and efficacy of nebulized lidocaine for upper airway anesthesia have previously been demonstrated. We determine whether nebulized lidocaine administered before nasogastric tube insertion significantly reduces patient discomfort. METHODS: A double-blind, placebo-controlled, randomized clinical trial of adult patients was conducted in the EDs of 2 university hospitals. Twenty-nine participants were administered nebulized lidocaine (4 mL 10%), and 21 participants received nebulized normal saline solution. Patient discomfort was measured using a 100-mm visual analog scale. The difficulty of nasogastric tube insertion was evaluated using a 5-point Likert scale. RESULTS: There was a clinical and statistical significant difference in patient discomfort associated with the passage of the nasogastric tube between nebulized lidocaine and placebo groups (mean visual analog scale score 37.7 versus 59.3 mm, respectively; difference between group means 21.6 mm; 95% confidence interval [CI] 5.3 to 38.0 mm). There was not a detectable difference in difficulty with the passage of the nasogastric tube between the 2 groups (median 2 versus 2; median difference 0; 95% CI -1 to 1). Epistaxis occurred more frequently in the lidocaine group (17% versus 0%; difference 17%; 95% CI 3.5% to 31%). CONCLUSION: Nebulized lidocaine decreases the discomfort of nasogastric tube insertion and should be considered before passing a nasogastric tube. An increased frequency of epistaxis, however, may be associated with its use.

Aged↗

PubMed2004

Treatment of asthma with nebulized lidocaine: a randomized, placebo-controlled study.

BACKGROUND: In 2 prior uncontrolled studies, nebulized lidocaine reduced oral glucocorticoid use in patients with severe glucocorticoid-dependent asthma. OBJECTIVE: We tested the safety and efficacy of nebulized lidocaine in a randomized, placebo-controlled study in patients with mild-to-moderate asthma. METHODS: We recruited 50 subjects (25 receiving lidocaine and 25 receiving placebo); all had a prebronchodilator FEV(1) of 64% to 125% of predicted normal value and were treated with daily inhaled glucocorticoids (but not systemic glucocorticoids) and bronchodilators for at least 2 months. Before treatment, subjects monitored their symptoms and peak flow values and maintained their medications for 2 weeks. At initiation, subjects inhaled either nebulized placebo (saline) or lidocaine (4%, 100 mg) 4 times daily. All subjects were instructed to reduce their inhaled glucocorticoid dosage by one half each week for 3 weeks and to discontinue glucocorticoid treatment at week 4. The subjects continued the nebulized lidocaine or placebo for a total of 8 weeks, monitored their symptoms, and used bronchodilators to control symptoms. RESULTS: Indicators of asthma severity showed benefit for the lidocaine-treated group: changes in FEV(1) (P < or =.001), nighttime awakenings (P < or =.02), symptoms (P < or =.010), bronchodilator use (P < or =.010), and blood eosinophil counts (P < or =.020). Subjects in both groups reduced use of inhaled glucocorticoids comparably. Subjects receiving nebulized placebo showed increases in their symptom scores, bronchodilator use (P < or =.05 for both), and blood eosinophil counts (P < or =.01) and decreases in FEV(1) (P < or =.001). CONCLUSION: Nebulized lidocaine provided effective and safe therapy in subjects with mild-to-moderate asthma.

Administration, Inhalation↗

PubMed2004

Comparison of nebulized epinephrine and terbutaline in patients with acute severe asthma: a controlled trial.

PURPOSE: To compare the efficacy and tolerability of nebulized adrenaline and terbutaline in acute severe asthma. METHODS DESIGN: Prospective pilot randomized double-blind cross-over trial. SETTING: Emergency department of a university hospital. PATIENTS: Thirty-eight patients admitted with severe acute asthma. Each patient received adrenaline (3 mg) and terbutaline (5 mg) nebulizations over 20 min in randomized order. Additional treatment comprised methylprednisolone, intravenous hydration, and oxygen. The efficacy and tolerability of the two drugs were evaluated at the end of each nebulization as well as potential synergistic effects. RESULTS: Eighteen patients received adrenaline first, and 20 received terbutaline first. Peak expiratory flow (PEF) improved significantly in both groups after the first nebulization (from 157 L/min +/- 111 L/min to 199 L/min +/- 134 L/min with adrenaline, P <.01; and from 142 L/min +/- 65 L/min to 193 L/min +/- 181 L/min with terbutaline, P <.01). Both drugs induced a significant decrease in respiratory frequency. The improvement in PaO2 was only significant with terbutaline. Respiratory frequency, PEF and PaO2 were not improved by the second nebulization. No adverse effects were observed. CONCLUSIONS: Adrenaline nebulization was as effective and as well tolerated as terbutaline in acute severe asthma. No synergistic effect between terbutaline and adrenaline was observed.

Acute Disease↗

PubMed2005

Nebulized versus subcutaneous morphine for patients with cancer dyspnea: a preliminary study.

This study compared the effects of nebulized versus subcutaneous morphine on the intensity of dyspnea in cancer patients. Patients with a resting dyspnea intensity > or =3 on a 0-10 scale (0=no dyspnea, 10=worst possible dyspnea) who received regular oral or parenteral opioids were included. On day 1, patients received either subcutaneous (SC) morphine plus nebulized placebo or nebulized morphine plus SC placebo. On day 2, a crossover was made. Dyspnea intensity, side effects, and blinded preference of treatment were assessed. Eleven patients completed the study. Dyspnea decreased from a median of 5 (range, 3-8) to 3 (range, 0-7) after SC morphine (P=0.025) and from 4 (range, 3-9) to 2 (range, 0-9) after nebulized morphine (P=0.007). There was no significant difference in dyspnea intensity between nebulized and subcutaneous morphine at 60 minutes. Unfortunately, due to limited sample size, there was insufficient power to rule out a significant difference between both routes of administration. Nebulized morphine offered dyspnea relief similar to that of SC morphine. Larger randomized controlled trials in patients with both continuous dyspnea and earlier stages of dyspnea are justified.

Administration, Inhalation↗

PubMed2005

A randomized clinical trial of magnesium sulphate as a vehicle for nebulized salbutamol in the treatment of moderate to severe asthma attacks.

Although it is well known that intravenous administration of MgSO4 as an adjunct to conventional therapy is effective in treating asthma attacks, the effect of nebulized MgSO4 as a vehicle for salbutamol has been less evaluated. The aim of this study was to compare the effects of nebulized salbutamol administrated through either MgSO4 or isotonic saline solution on the 'peak expiratory flow rate' (PEFR), other respiratory and clinical parameters, and hospitalization rate of patients suffering from moderate to severe asthma attacks. Twenty-six patients with asthma attack were enrolled in the study in a randomized single blind fashion. After obtaining initial peak expiratory flow measurements (PEFR) and clinical evaluation, all patients received 1mg/kg corticosteroids and oxygen therapy and then either isotonic MgSO4 (2.5 ml, 6.3%)+salbutamol (2.5 ml) or saline (2.5 ml)+salbutamol (2.5 ml) through a jet nebulizer (group 1 (n=14) vs group 2 (n=12), respectively). The nebulizations were repeated every 20 min for the first hour and every hour for the rest of 4 h. The PEFR measurements and clinical assessment were performed after nebulization at 20th, 60th, 120th, 180th and 240th minutes. Patients were discharged when PEFR reached the target level of 70% of predicted. The baseline PEFRs and clinical parameters were similar between groups 1 and 2 (50.2+/-18.5 vs 44.1+/-13.9, respectively, p>0.05). The mean% increase in PEFR at different measurement levels was similar between the groups. When the treatment response was evaluated within the groups, group 2 showed statistically significant increase in PEFR (% of predicted) 1h earlier than group 1 (60th vs 120th minute, p=0.003 vs p=0.007). The mean duration of achieving target-PEFRs was 105.7+/-72.1 min for group 1 and 118.3+/-96.7 min for group 2 (p>0.05). This study suggested that the additional usage of MgSO4 to nebulized salbutamol has no beneficial effect on the treatment of asthma attacks.

Adolescent↗

PubMed1993

Efficacy of albuterol administered by nebulizer versus spacer device in children with acute asthma.

The aim of this study was to compare the response to inhaled albuterol after administration by nebulizer with the response after administration by a metered-dose inhaler and spacer device (MDI-spacer) to children with acute asthma. In a double-blind fashion, 33 children (6 to 14 years of age) with forced expiratory volume in 1 second (FEV1) between 20% and 70% of predicted values, and who were seen in the emergency department with acute asthma, were studied. They were treated with aerosolized albuterol or placebo by MDI-spacer, followed immediately by albuterol or placebo administered by nebulizer with oxygen. The dose ratio for albuterol by MDI-spacer versus nebulizer was 1:5. Outcome measures included a clinical score, respiratory rate, arterial oxygen saturation, and FEV1, measured before and 10, 20, and 40 minutes after treatment. With the exception of heart rate (which increased in the nebulizer group and decreased in the MDI-spacer group (p < 0.05), no difference in the rate of improvement of clinical score, respiratory rate, arterial oxygen saturation, or FEV1 was noted during the 40-minute study period between children who received albuterol by nebulizer and those who received it by MDI-spacer. We conclude that spacers and nebulizers are equally effective means of delivering beta 2-agonists to children with acute asthma.

Acute Disease↗

PubMed2003

Stenotrophomonas maltophilia contamination of nebulizers used to deliver aerosolized therapy to inpatients with cystic fibrosis.

There is circumstantial evidence that nebulizer equipment may be a source of Stenotrophomonas maltophilia for patients with cystic fibrosis. Eighty-nine inpatient nebulizers were examined for evidence of S. maltophilia contamination of which nine (10%) yielded 14 strains of the bacterium. Environmental samples were obtained from 73 different sites on the ward, of which 17 (23%) yielded a further 21 strains. Positive sites included taps, sink drains, and potable water. Genotyping using ERIC-PCR and pulsed-field gel electrophoresis revealed that two pairs of patients' nebulizers were contaminated with closely related strains. None of the S. maltophilia isolates obtained from the ward environment shared genotypes with those obtained from the nebulizers. The frequency of isolation of S. maltophilia from potable water sources on the ward suggests that contamination may result from using it to clean reusable nebulizer equipment, particularly if this is followed by inadequate drying. Although the actual source of S. maltophilia contamination of hospital-use nebulizer equipment in this study remained elusive, these results have important infection control implications.

Adolescent↗

PubMed1993

Continuous versus intermittent albuterol nebulization in the treatment of acute asthma.

STUDY OBJECTIVES: To compare bronchodilation, chronotropic effects, and side effects of the same dose of nebulized albuterol when given by either intermittent or continuous administration. DESIGN: A randomized assignment of patients to one of the two methods of albuterol nebulization. SETTING: Adult emergency department in an urban public hospital. TYPE OF PARTICIPANTS: Adult patients with acute exacerbations of asthma. INTERVENTIONS: Administration of 30 mg albuterol given over 110 minutes by either continuous or intermittent aerosolization. MEASUREMENTS: FEV1, forced vital capacity, heart rate, and systolic and diastolic blood pressures were measured immediately before treatment and then hourly for two hours. Side effects, symptoms, subsequent admission, and discharge also were noted. MAIN RESULTS: An overall significant decrease in heart rate was observed, indicating the lack of significant chronotropic effects with this dose of albuterol. Both treatments resulted in significant spirometric improvement without a significant treatment difference for the entire group. A difference, however, was found in the relative rates of FEV1 improvement with the two treatments depending on whether patients had an initial FEV1 less than or more than 50% predicted (P = .05). A secondary analysis on patients with an initial FEV1 less than percent predicted demonstrated a higher rate of percent predicted FEV1 increase with the continuously nebulized albuterol group (P = .03). CONCLUSION: This study demonstrates that albuterol can be given safely at this dose by either intermittent or continuous nebulization. Future studies should examine whether continuous nebulization has a reproducible advantage over intermittent nebulization in patients with more severe obstruction.

Acute Disease↗

PubMed1998

Salbutamol treatment of acute severe asthma in the ED: MDI versus hand-held nebulizer.

The objectives of this study were to compare the efficacy of salbutamol delivered by either metered-dose inhaler plus spacer (MDI-spacer) or by wet nebulization (NEB), and to determine the relationships between physiologic responses and plasma salbutamol concentrations. Asthmatic patients presenting to the emergency department (ED) with acute severe asthma (forced expiratory volume in the first second [FEV1] less than 50% of predicted) were enrolled in a randomized, double-blind, parallel-group study. The MDI-spacer group received salbutamol, delivered via MDI into a spacer device, in four puffs actuated in rapid succession at 10-minute intervals (2.4 mg/h). The NEB group was treated with nebulized salbutamol, 1.5 mg, via nebulizer at 15-minute intervals (6 mg/h). Doses were calculated on the basis of the percentage of total dose that reaches the lower airway with both methods. The protocol involved 3 hours of this treatment. Mean peak expiratory flow rate (PEFR) and FEV1 improved significantly over baseline values for both groups (P=.01). However, there were no significant differences between both groups for PEFR and FEV1 at any point studied. The examination of the relationships between cumulative dose of salbutamol and change in FEV1 showed a significant linear relationship (P=.01) for both methods (MDI r=.97; NEB r=.97). The regression equations showed that for every 1 mg of salbutamol by MDI-spacer, 2.5 mg are needed from nebulization to have equal therapeutic response. At the end of treatment, the salbutamol plasma levels were 10.1+/-1.6 ng/ml for the MDI-spacer group and 14.4+/-2.3 ng/ml for the NEB group (P=.0003). Both groups showed a nonsignificant heart rate decrease. A significant group-by-time interaction means that differences between groups increased with time (P=.04). Additionally, the NEB group presented a higher incidence of tremor (P=.03) and anxiety (P=.04), reflecting larger systemic absorption of salbutamol. These data indicate that when doses used are calculated on the basis of the percentage of total drug that reaches the lower airway, there was equivalent bronchodilatation after salbutamol administered by either MDI-spacer or nebulization in patients with acute severe asthma. However, nebulizer therapy produced greater side effects related to the increase in salbutamol absorption and higher plasma level.

Acute Disease↗

PubMed2001

Lectin-functionalized liposomes for pulmonary drug delivery: effect of nebulization on stability and bioadhesion.

The generation of respirable aerosols of a functionalized colloidal carrier has been investigated in this study. Lectin-functionalized liposomes, which proved to show improved cell association (using A549 cell line and primary human alveolar cells) even in the presence of a commercial lung surfactant preparation, have been developed. The stability of non-functionalized liposomes during nebulization using a jet nebulizer (Pari II provocation nebulizer, operated using an air flow of 30 l/min) was firstly investigated, and the experimental and formulation conditions were optimized and applied for the preparation of lectin-functionalized liposomes. The incorporation of cholesterol enhanced the stability of the liposomes during nebulization (from 15-20% leakage of a hydrophilic marker to 8% upon cholesterol incorporation) and upon incubation with lung surfactant preparation. Nebulization of the functionalized liposomes did not significantly influence their physical stability. Their enhanced cell binding capability (compared to non-functionalized liposomes) was also maintained. A drop in cell association compared to fresh functionalized liposomes was detected after nebulization, nevertheless, the binding was still significantly higher than that of the non-functionalized liposomes. The deposition of the liposomal preparation in lung periphery, proved by the deposition of the liposomal preparation on the lower stages of an ASTRA type cascade impinger and a mean median aerodynamic diameter (MMAD) of 2.85 microm, makes it a potential candidate as a macromolecule-drug carrier for local and/or systemic administration.

1,2-Dipalmitoylphosphatidylcholine↗

PubMed1991

Variability in the measurement of nebulized aerosol deposition in man.

1. This study was performed to determine the variability of two different scintigraphic methods of measuring pulmonary aerosol deposition, and to examine nebulizer particle size and drug output as potential sources of this variability. 2. A radioaerosol was produced from a 3 ml solution of 99mTc-labelled colloidal human serum albumin (0.05 mg, 37 MBq) using a standard jet nebulizer and air compressor. This was inhaled on three separate occasions by nine healthy male subjects. One one of these occasions, a further inhalation was performed to assess immediate repeatability using increased 99mTc activity (92 MBq). 3. Intrapulmonary aerosol deposition was measured with a gamma-camera and was corrected for tissue attenuation and geometric distribution by using two different methods. 4. Estimated mean pulmonary deposition was 4.3% of the nebulizer dose using a lung phantom correction method, and 6.1% using a tissue attenuation method. For these two methods respectively variability between subjects (coefficient of variation) was 54 and 47%. For both methods, within-subject variability (coefficient of variation) was 37% between occasions and 23% within occasions. 5. The particle-size output of several nebulizers was highly reproducible (coefficient of variation less than 4%), but the nebulizer mass and radionuclide output of two nebulizers was more variable (coefficient of variation 5-19%), and appeared to be an important contributor to the variability in pulmonary aerosol deposition. 6. The data presented here for pulmonary deposition, used with appropriate power statistics formulae, can be used to estimate the sample sizes required for comparative studies of lung aerosol deposition.

Aerosols↗

PubMed2003

Prescribing and administration of nebulized bronchodilators: a prospective audit in a university hospital.

OBJECTIVE: Inaccurate and incomplete prescribing of nebulized bronchodilators can result in uncertainty and suboptimal treatment. A prospective study was carried out to assess the completeness of prescription and the quality of bronchodilator drug administration via nebulizers. METHODOLOGY: A total of 121 consecutive inpatient nebulized bronchodilator prescriptions and treatments administered to 93 adult medical inpatients in a university hospital were studied prospectively. Five different aspects of the prescriptions were examined to assess their accuracy and completeness. The administration of each nebulizer treatment was studied using audit of medication charts and interview with ward nurses. RESULTS: No prescription was correct and complete in all five aspects assessed. The most common mistake was failure to state the type and flow rate of driving gas (100%). This was followed by failure to prescribe recommended doses of bronchodilators (46%) and failure to give unambiguous instruction on frequency of treatment (39%). It was found that in only 21.5% of instances was the administration of nebulized bronchodilator drugs optimal. CONCLUSION: This prospective audit has demonstrated major deficiencies in the prescribing and administration of nebulized bronchodilators and it has highlighted the need for a local protocol and continuing staff education. The alternative method of administering bronchodilator via metered dose inhaler with large volume spacer should be evaluated in the treatment of acute airflow obstruction in hospitalized patients.

Administration, Inhalation↗