Table 3.

Practical recommendations to improve inhaled drug deposition with nebulizers

Using vibrating-mesh nebulizers with minimal drug retention and no risk of protein denaturation as observed with ultrasonic nebulizers [18, 27, 28, 34, 41]

Promoting inspiratory synchronized nebulizers [27, 28, 31, 35]

Combining an inhalation chamber with constant-output nebulizers (to be confirmed in further studies) [22]

Generating aerosol particles in a dry circuita [31]

Controlling the breathing pattern (high Tinsp/TTOT a, low inspiratory flow) in volume control mode [18]

Using a helium-oxygen mixture as inhaled gas [48]

^aProbably not relevant with a recent prototype of inspiratory synchronized vibrating-mesh nebulizer, as suggested by Luyt et al. [27]