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J Aerosol Med Pulm Drug Deliv. 2013 Oct;26(5):280-6. doi: 10.1089/jamp.2012.0993. Epub 2012 Dec 28.

Vibrating membrane devices deliver aerosols more efficient than standard devices: a study in a neonatal upper airway model.

Author information

1
1 Princess Amalia Department of Paediatrics, Division of Neonatology, Isala Clinics , 8000 GK Zwolle, The Netherlands .

Abstract

BACKGROUND:

Aerosol therapy in preterm infants is challenging, as a very small proportion of the drug deposits in the lungs.

AIM:

Our aim was to compare efficiency of standard devices with newer, more efficient aerosol delivery devices.

METHODS:

Using salbutamol as a drug marker, we studied two prototypes of the investigational eFlow(®) nebulizer for babies (PARI Pharma GmbH), a jet nebulizer (Intersurgical(®) Cirrus(®)), and a pressurized metered dose inhaler (pMDI; GSK) with a detergent-coated holding chamber (AeroChamber(®) MV) in the premature infant nose throat-model (PrINT-model) of a 32-week preterm infant (1,750 g). A filter or an impactor was placed below the infant model's "trachea" to capture the drug dose or particle size, respectively, that would have been deposited in the lung.

RESULTS:

Lung dose (percentage of nominal dose) was 1.5%, 6.8%, and 18.0-20.6% for the jet nebulizer, pMDI-holding chamber, and investigational eFlow nebulizers, respectively (p<0.001). Jet nebulizer residue was 69.4% and 10.7-13.9% for the investigational eFlow nebulizers (p<0.001). Adding an elbow extension between the eFlow and the model significantly lowered lung dose (p<0.001). A breathing pattern with lower tidal volume decreased deposition in the PrINT-model and device residue (p<0.05), but did not decrease lung dose.

CONCLUSIONS:

In a model for infant aerosol inhalation, we confirmed low lung dose using jet nebulizers and pMDI-holding chambers, whereas newer, more specialized vibrating membrane devices, designed specifically for use in preterm infants, deliver up to 20 times more drug to the infant's lung.

PMID:
23273244
DOI:
10.1089/jamp.2012.0993
[Indexed for MEDLINE]
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