Download, PDF, 1.7 Mb.

IMPROVED AEROSOL DELIVERY WITH A CONSERVER-TYPE NEBULIZER SYSTEM
POWERED BY 6 COMMON HOME AIR COMPRESSORS
Douglas S Gardenhire, EdD, RRT-NPS, FAARC;
Georgia State University, Division of Respiratory Therapy, Atlanta GA, USA.
Presented at the North American Cys@c Fibrosis Conference, Salt Lake City, UT, Oct. 17-­‐19, 2013. Abstract in Pediatric Pulmonology 2013; 48(S36): 352. 1. Purpose
3. Results
This study was designed and conducted to
determine if a conserver-type SVN (Westmed
Circulaire II Hybrid High-Efficiency Aerosol Drug
Delivery System) would improve the mass of
medication (Inhaled Aerosol, IA) delivered by
home air compressors. The Hybrid uses a 350 mL
elastomeric sphere as an aerosol-conserving
reservoir, while the other SVNs are either “teetype” or breath-enhanced devices.
A repeated measure Analysis of Variance (ANOVA) showed a difference between nebulizers
when used with the compressors tested, F(40,108)= 5.22, p=.000. Tukey post hoc testing was
completed for each of the nebulizers. Mean (±SD) IA and significance of nebulizers are shown
in Figure 1. The IA output of each nebulizer compared to compressor at 6 minutes is found in
Figure 2.
4. Conclusion
Optimal function of an SVN is
dependent on proper driving
pressure and flow, which apparently
cannot be uniformly achieved by
some air compressor and nebulizer
combinations. The conserving effect
of the Westmed Circulaire II Hybrid
appears to compensate for
marginally performing home air
compressors and outperforms all
other SVNs tested. The Circulaire II
Hybrid delivered from 1.6 to 2.8
times more medication than other
nebulizers operated with the same
air compressors. Composite data is
shown in Figure 3.
Figure 1 Westmed Circulaire II Hybrid, High-­‐Efficiency Aerosol Drug Delivery System 6 minute data Figure 2 2. Methods
9 different SVNs, including the Hybrid, were operated on 6 different new air
compressors (DeVilbiss Pulmo-Aide, Pulmo-Aide Compact, Salter Aire Plus, Pari
Vios, Respironics Inspiration Elite and Invacare Select) that were selected based
on their availability. SVNs were charged with 3 mL of 0.083% albuterol unit dose
solution and operated for 6 mins each. Aerosol was captured on a filter at the
“mouth” of an Ingmar ASL5000 breathing simulator (f=15, VT=500 mL, I:E=1:3).
Filters were washed to elute albuterol, which was measured via
spectrophotometer. Each SVN was washed and dried before first use and inbetween test runs. Tests were done in triplicate and averaged.
Compressor Supplied Nebulizer Brand Hybrid Inhaled Mass (mg) @ 6 min % Change @ 6 mins. DeVilbiss Pulmo-­‐Aide VixOne 0.419 0.744 78% Pulmo-­‐Aide Compact VixOne 0.507 0.725 43% LC Plus Sprint 8900 Sidestream 0.422 0.398 0.733 74% 84% 0.333 0.689 107% Sidestream Plus 0.451 Invacare 0.274 0.631 130% 0.385 0.084
21.8% 0.695 0.048
6.9% 81% -­‐-­‐-­‐ -­‐-­‐-­‐ Pari Vios Salter Aire Plus Philips Respironics InspiraLon Elite Invacare Select Figure 3 Mean: SD: CV: 0.274 0.645 135% 43%