Newman S P, Pellow P G, Clay M M, Clarke S W
Thorax. 1985 Sep;40(9):671-6. doi: 10.1136/thx.40.9.671.
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.
最近，雾化抗生素（庆大霉素和羧苄青霉素）已成功用于治疗囊性纤维化患者的呼吸道感染。然而，对于雾化器的选择或使用通常很黏稠的抗生素溶液的理想操作模式，尚无相关信息。我们评估了四种常见品牌的喷射雾化器（Bird、德维比斯、英普朗特和Upmist）的气溶胶输出量、液滴大小和雾化时间，这些雾化器在四种压缩气体流速（6、8、10和12升·分钟⁻¹）下用于雾化2毫升（80毫克）和4毫升（160毫克）的庆大霉素溶液（硫酸庆大霉素，柯比 - 沃里克）。不同雾化器之间存在相当大的差异，德维比斯和Upmist在释放可吸入（直径小于5微米）液滴方面效率最高。液滴大小和雾化时间与气体流速成反比。通过将填充体积从2毫升增加到4毫升，气溶胶输出量和雾化时间会增加，不过在12升·分钟⁻¹的流速下，使用德维比斯和Upmist时，雾化时间仍可限制在12分钟或更短。根据雾化器类型、流速和填充体积的不同，直径小于5微米的液滴中的药物输出量在7.2（标准误0.4）至71.4（4.3）毫克之间。这些研究表明，为了实现最佳药物递送，应使用固定流速为10 - 12升·分钟⁻¹的设备或高流量压缩机来雾化4毫升庆大霉素溶液。先前抗生素气溶胶临床效果不理想可能部分归因于雾化器选择不当或操作条件不合适，或两者皆有。
