Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1985 Sep;40(9):671–676. doi: 10.1136/thx.40.9.671

Evaluation of jet nebulisers for use with gentamicin solution.

S P Newman, P G Pellow, M M Clay, S W Clarke
PMCID: PMC460168  PMID: 4060108

Abstract

Recently nebulised antibiotics (gentamicin and carbenicillin) have been used successfully to treat respiratory tract infection in patients with cystic fibrosis. No information exists, however, on the choice of nebuliser or the ideal mode of operation with antibiotic solutions, which are often viscous. The aerosol output, droplet size, and nebulisation time were assessed for four common brands of jet nebuliser (Bird, DeVilbiss, Inspiron, and Upmist) used to nebulise 2 ml (80 mg) and 4 ml (160 mg) of gentamicin solution (Garamycin, Kirby-Warrick) at four compressed gas flow rates (6, 8, 10, and 12 1 . min-1). There were considerable variations between the nebulisers, DeVilbiss and Upmist being most efficient in the release of respirable (less than 5 micron diameter) droplets. Droplet size and nebulisation time were inversely proportional to gas flow rate. Aerosol output and nebulisation time were increased by raising the volume fill from 2 to 4 ml, although nebulisation time could still be restricted to 12 minutes or less with DeVilbiss and Upmist at 12 1 . min-1. The output of drug in droplets of below 5 micron diameter ranged from 7.2 (SE 0.4) to 71.4 (4.3) mg, according to the type of nebuliser, flow rate, and volume fill. These studies suggest that for optimal drug delivery 4 ml gentamicin solution should be nebulised either at a fixed flow rate of 10-12 1 . min-1 or with a high flow compressor. Previous unsatisfactory clinical results with antibiotic aerosols may have been due in part to incorrect choice of nebuliser or inappropriate operating conditions, or both.

Full text

PDF
671

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Asmundsson T., Johnson R. F., Kilburn K. H., Goodrich J. K. Efficiency of nebulizers for depositing saline in human lung. Am Rev Respir Dis. 1973 Sep;108(3):506–512. doi: 10.1164/arrd.1973.108.3.506. [DOI] [PubMed] [Google Scholar]
  2. Clay M. M., Pavia D., Newman S. P., Clarke S. W. Factors influencing the size distribution of aerosols from jet nebulisers. Thorax. 1983 Oct;38(10):755–759. doi: 10.1136/thx.38.10.755. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Clay M. M., Pavia D., Newman S. P., Lennard-Jones T., Clarke S. W. Assessment of jet nebulisers for lung aerosol therapy. Lancet. 1983 Sep 10;2(8350):592–594. doi: 10.1016/s0140-6736(83)90679-7. [DOI] [PubMed] [Google Scholar]
  4. Dolovich M. B., Killian D., Wolff R. K., Obminski G., Newhouse M. T. Pulmonary aerosol deposition in chronic bronchitis: intermittent positive pressure breathing versus quiet breathing. Am Rev Respir Dis. 1977 Mar;115(3):397–402. doi: 10.1164/arrd.1977.115.3.397. [DOI] [PubMed] [Google Scholar]
  5. Hodson M. E., Penketh A. R., Batten J. C. Aerosol carbenicillin and gentamicin treatment of Pseudomonas aeruginosa infection in patients with cystic fibrosis. Lancet. 1981 Nov 21;2(8256):1137–1139. doi: 10.1016/s0140-6736(81)90588-2. [DOI] [PubMed] [Google Scholar]
  6. Lin M. S., Hayes T. M., Goodwin D. A., Kruse S. L. Distal penetration in radioaerosol inhalation with an ultrasonic nebulizer. Radiology. 1974 Aug;112(2):443–446. doi: 10.1148/112.2.443. [DOI] [PubMed] [Google Scholar]
  7. Mercer T. T., Goddard R. F., Flores R. L. Effect of auxiliary air flow on the output characteristics of compressed-air nebulizers. Ann Allergy. 1969 May;27(5):211–217. [PubMed] [Google Scholar]
  8. Mercer T. T. Production of therapeutic aerosols; principles and techniques. Chest. 1981 Dec;80(6 Suppl):813–818. [PubMed] [Google Scholar]
  9. Newman S. P., Clarke S. W. Therapeutic aerosols 1--physical and practical considerations. Thorax. 1983 Dec;38(12):881–886. doi: 10.1136/thx.38.12.881. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Sterk P. J., Plomp A., van de Vate J. F., Quanjer P. H. Physical properties of aerosols produced by several jet- and ultrasonic nebulizers. Bull Eur Physiopathol Respir. 1984 Jan-Feb;20(1):65–72. [PubMed] [Google Scholar]
  11. Wall M. A., Terry A. B., Eisenberg J., McNamara M., Cohen R. Inhaled antibiotics in cystic fibrosis. Lancet. 1983 Jun 11;1(8337):1325–1325. doi: 10.1016/s0140-6736(83)92428-5. [DOI] [PubMed] [Google Scholar]
  12. Williams M. H., Jr Conference on the scientific basis of respiratory therapy. Aerosol therapy. Steroid and antibiotic aerosols. Am Rev Respir Dis. 1974 Dec;110(6 Pt 2):122–128. doi: 10.1164/arrd.1974.110.6P2.122. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES