1 Physiology and Experimental Medicine-Research Institute, Hospital for Sick Children, University of Toronto , Toronto Canada .
J Aerosol Med Pulm Drug Deliv. 2014 Feb;27(1):66-70. doi: 10.1089/jamp.2013.1036. Epub 2013 Apr 15.
The two American Thoracic Society recommended aerosol delivery devices for methacholine challenge testing are both obsolete and often very difficult to acquire, leading to the test being done with a number of nonstandardized nebulizers. Of the two recommended devices, one is the English Wright nebulizer used in the 2-min tidal breathing method, and the other is the DeVilbiss 646 nebulizer used in the five-breath dosimeter method. The purpose of this study was to evaluate the in vitro performance of potential alternative devices that would be economically viable and would minimize environmental contamination. One device was the disposable breath-actuated AeroEclipse(®) II BAN as a potential delivery system for the 2-min tidal breathing, and the second was the automated system by VIASYS as an alternative to either the 2-min tidal breathing or the five-breath dosimeter method.
A breath simulator mimicked an adult or small child breathing pattern, and a slow inhalation for the five-breath method was generated by a spirometry calibration syringe. Methacholine (Provocholine™) was eluted from filters at the "mouth" and assayed by high-pressure liquid chromatography.
In 12 sec, the AeroEclipse II BAN would be expected to have a pulmonary deposition equivalent to the 2-min tidal breathing with the English Wright, whereas the VIASYS system would take approximately 40 sec for the equivalent delivery. The per-breath delivery of the VIASYS and the DeVilbiss 646 was approximately the same, whereas one breath from the AeroEclipse II BAN was the equivalent of five from the DeVilbiss 646.
These data will allow for planning in vivo studies to develop methacholine challenge protocols using modern aerosol delivery systems.
美国胸科学会推荐的两种用于乙酰甲胆碱激发试验的雾化器都已过时，而且通常很难获得，导致该试验使用了许多非标准化的雾化器。在这两种推荐的设备中，一种是用于 2 分钟潮气呼吸法的英文 Wright 雾化器，另一种是用于 5 次呼吸剂量计法的 DeVilbiss 646 雾化器。本研究的目的是评估潜在替代设备的体外性能，这些替代设备在经济上可行，并将最大限度地减少环境污染。一种设备是一次性呼吸触发的 AeroEclipse(®) II BAN，作为 2 分钟潮气呼吸的潜在输送系统，第二种是 VIASYS 的自动化系统，作为 2 分钟潮气呼吸或 5 次呼吸剂量计法的替代方法。
呼吸模拟器模拟成人或儿童的呼吸模式，通过肺活量校准注射器产生用于 5 次呼吸法的缓慢吸入。乙酰甲胆碱（Provocholine™）从过滤器中洗脱，并通过高压液相色谱进行分析。
在 12 秒内，预计AeroEclipse II BAN 将具有与英文 Wright 2 分钟潮气呼吸相当的肺部沉积，而 VIASYS 系统将需要大约 40 秒的等效输送。VIASYS 和 DeVilbiss 646 的每口气输送量大致相同，而从 AeroEclipse II BAN 吸入一口气相当于从 DeVilbiss 646 吸入五口气。
这些数据将为使用现代雾化器输送系统制定乙酰甲胆碱激发试验方案的体内研究提供规划依据。
