No differences? Aerosol characteristics of 9 jet nebulisers tested in vitro

Nebulisers are recommended in the treatment of severe and exacerbating COPD (GOLD Guidelines 2013). As choosing the right system can be a crucial factor for a successful aerosol therapy, the performance of 9 relevant jet nebulisers was determined. Methods Aerosol delivery of albuterol (Sultanol forte® 2.5 mg/2.5 ml) was assessed over 4 min and analysed by HPLC. Adult breathing pattern (Ph.Eur.7.0) was mimicked with a PARI Compas II breath simulator (n=5/6). The aerodynamic particle size distribution was determined by a Next Generation Impactor (Ph.Eur.7.0, Copley Scientific, 15 L/min, n=3). Respirable Drug Delivery Rate (RDDR) was calculated by multiplying the Drug Delivery Rate (DDR) by the Respirable Fraction (% of droplets ≤ 5µm). Results The DDR during the first 4 min of nebulisation differed from maximal 196 µg/min (PARI LC SPRINT,blue insert) to 67 µg/min (Ampolla Nebjet). The RDDR (predictor for the respirable drug dose per time) varied by a factor of 3.5 between the systems tested. Nebuliser *MMAD [µm] RDDR [≤ 5µg/min] PARI LC SPRINT® (blue insert)/ PARI BOY®SX 3.3 134 PARI LC SPRINT® Star (red insert)/ PARI BOY®SX 2.8 131 MPV Family Medel Jet®/ MicroDrop® 3.9 65 MPV MicroDrop® Pro/ MicroDrop® 3.7 76 Omron V.V.T.01/ Omron CompAir NE-C28P 3.9 76 Omron V.V.T.01/ Omron CompAir NE-C801 4.2 47 Sidestream reusable/ Respironics Inspiration Elite 3.2 56 Sidestream reusable/ Portaneb Respironics 3.0 86 Ampolla Nebjet/ MIDINEB (3A Health Care) 4.3 38 *Mass Median Aerodynamic Diameter Conclusion In vitro aerosol performance of the 9 tested nebulisers differs considerably. Nebulisers with a high RDDR ensure most likely the best effective intrapulmonary deposition within a short time, which is relevant for adherence.