SPECT-CT Comparison of Lung Deposition using a System combining a Vibrating-mesh Nebulizer with a Valved Holding Chamber and a Conventional Jet Nebulizer: a Randomized Cross-over Study.

Jonathan Dugernier, Michel Hesse, Rita Vanbever, Virginie Depoortere, Jean Roeseler, Jean-Bernard Michotte, Pierre-François Laterre, François Jamar, Gregory Reychler

Journal: Pharmaceutical research 2017;34(2):290-300

PMID: 27822851

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Abstract

PURPOSE

To compare in vivo the total and regional pulmonary deposition of aerosol particles generated by a new system combining a vibrating-mesh nebulizer with a specific valved holding chamber and constant-output jet nebulizer connected to a corrugated tube.

METHODS

Cross-over study comparing aerosol delivery to the lungs using two nebulizers in 6 healthy male subjects: a vibrating-mesh nebulizer combined with a valved holding chamber (Aerogen Ultra®, Aerogen Ltd., Galway, Ireland) and a jet nebulizer connected to a corrugated tube (Opti-Mist Plus Nebulizer®, ConvaTec, Bridgewater, NJ). Nebulizers were filled with diethylenetriaminepentaacetic acid labelled with technetium-99 m (Tc-DTPA, 2 mCi/4 mL). Pulmonary deposition of Tc-DTPA was measured by single-photon emission computed tomography combined with a low dose CT-scan (SPECT-CT).

RESULTS

Pulmonary aerosol deposition from SPECT-CT analysis was six times increased with the vibrating-mesh nebulizer as compared to the jet nebulizer (34.1 ± 6.0% versus 5.2 ± 1.1%, p < 0.001). However, aerosol penetration expressed as the three-dimensional normalized ratio of the outer and the inner regions of the lungs was similar between both nebulizers.

CONCLUSIONS

This study demonstrated the high superiority of the new system combining a vibrating-mesh nebulizer with a valved holding chamber to deliver nebulized particles into the lungs as comparted to a constant-output jet nebulizer with a corrugated tube.

Address: Institut de Recherche Expérimentale et Clinique (IREC), Pneumologie, ORL & Dermatologie, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium. [email protected].; Soins Intensifs, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium. [email protected].; Médecine Physique, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium. [email protected].; Médecine Nucléaire, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium.; Louvain Drug Research Institute (LDRI), Université Catholique de Louvain, Avenue Hippocrate 10, 1200, Brussels, Belgium.; Soins Intensifs, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium.; Haute Ecole de Santé Vaud, Filière physiothérapie, University of Applied Sciences and Arts Western Switzerland, Avenue de Beaumont 21, 1011, Lausanne, Switzerland.; Institut de Recherche Expérimentale et Clinique (IREC), Pneumologie, ORL & Dermatologie, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium.; Médecine Physique, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium.; Pneumologie, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium.

DOI: 10.1007/s11095-016-2061-7

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MeSH Terms: Administration, Inhalation, Adult, Aerosols, Cross-Over Studies, Drug Delivery Systems, Equipment Design, Healthy Volunteers, Humans, Inhalation Spacers, Lung, Male, Nebulizers and Vaporizers, Particle Size, Prostheses and Implants, Technetium, Technetium Tc 99m Pentetate, Tomography, Emission-Computed, Single-Photon, Tomography, X-Ray Computed