Coates A L, MacNeish C F, Lands L C, Meisner D, Kelemen S, Vadas E B
Hospital for Sick Children of the University of Toronto, Ontario, Canada.
Chest. 1998 Apr;113(4):951-6. doi: 10.1378/chest.113.4.951.
To compare drug output from a vented nebulizer (Pari LC Jet Plus) with a traditional unvented nebulizer (Hudson 1730 T Up-Draft 11) using aerosolized tobramycin, which is frequently used in the treatment of cystic fibrosis.
Six nebulizers of each type were filled with a 4 mL tobramycin (80 mg) solution and were driven by a compressor (Pulmo-Aide). Various inspiratory flows (VI) (0, 5, 10, 15, 20 L/min for the Pari LC Jet Plus and 0, 5, and 10 L/min for the Hudson 1730, all at 40% relative humidity) were directed through each nebulizer. Drug output was measured from changes in weight and concentration (assessed by changes in osmometry) within the nebulizer. Particle size distributions were determined by laser diffraction allowing the calculation of the amount of aerosol output in the respirable range (<5 microm). The nebulizers were first run until end-nebulization to establish total drug output and then for either 4 or 5 min to determine the rate of drug output (mg/min) before intermittent aerosol output.
The total drug output without VI for both the unvented and the vented nebulizers was not significantly different, 55 (51, 60) mg for the Hudson 1730 vs 51 (49, 53) mg for the Pari LC Jet Plus (mean [95% confidence limits]). Inspiratory flow had no effect on the unvented Hudson 1730 nebulizer but significantly increased the rate of total drug output and the rate of drug output in the respirable range for the vented Pari LC Jet Plus nebulizer (VI=0, 3.35 [2.84, 3.85] and 1.72 [1.48, 1.96] compared with VI=20, 9.87 [9.03, 10.70] and 6.11 [5.33, 6.88] mg/min).
These findings indicate that the increase in the rate of drug output with VI for the vented nebulizer would result in shorter nebulization times and a relative decrease in drug loss during the expiratory phase.
比较雾化妥布霉素（常用于治疗囊性纤维化）时，带 vented 装置的雾化器（Pari LC Jet Plus）与传统无 vented 装置的雾化器（Hudson 1730 T Up-Draft 11）的药物输出量。
每种类型的六个雾化器均装入 4 mL 妥布霉素（80 mg）溶液，并由压缩机（Pulmo-Aide）驱动。使各种吸气流量（VI）（Pari LC Jet Plus 为 0、5、10、15、20 L/min，Hudson 1730 为 0、5 和 10 L/min，均在 40%相对湿度下）通过每个雾化器。通过雾化器内重量和浓度的变化（通过渗透压测定法的变化评估）来测量药物输出量。通过激光衍射确定粒径分布，从而计算可吸入范围内（<5 微米）的气溶胶输出量。首先运行雾化器直至雾化结束以确定总药物输出量，然后运行 4 或 5 分钟以确定间歇性气溶胶输出前的药物输出速率（mg/min）。
无 VI 时，无 vented 装置的雾化器和带 vented 装置的雾化器的总药物输出量无显著差异，Hudson 1730 为 55（51, 60）mg，Pari LC Jet Plus 为 51（49, 53）mg（均值[95%置信区间]）。吸气流量对无 vented 装置的 Hudson 1730 雾化器无影响，但显著提高了带 vented 装置的 Pari LC Jet Plus 雾化器的总药物输出速率和可吸入范围内的药物输出速率（VI = 0 时，分别为 3.35[2.84, 3.85]和 1.72[1.48, 1.96]，与 VI = 20 时的 9.87[9.03, 10.70]和 6.11[5.33, 6.88]mg/min 相比）。
这些发现表明，带 vented 装置的雾化器随 VI 增加的药物输出速率提高，将导致雾化时间缩短以及呼气阶段药物损失相对减少。
