Raabe O G, Wong T M, Wong G B, Roxburgh J W, Piper S D, Lee J I
Vortran Medical Technology, Inc, Sacramento, California, USA.
Ann Allergy Asthma Immunol. 1998 Jun;80(6):499-508. doi: 10.1016/S1081-1206(10)63074-8.
Various studies have demonstrated the benefits of continuous nebulization therapy for delivering aerosols of the beta2 agonists such as terbutaline sulfate or albuterol sulfate to patients with severe asthma and/or impending respiratory failure.
The purpose of this investigation was to explicate the operational factors associated with the use of nebulizers for extended aerosol respiratory therapy including those factors that affect the prescribed aerosol dosages and the relationship to actual delivery of prescribed drugs to the respiratory airways of the lungs of a patient under treatment conditions.
Operational characteristics and methods have been investigated for use of long-running nebulizers for continuous nebulization therapy. Factors considered were particle size distribution, setup conditions, aerosolization concentrations and rates, delivery fraction of aerosol reaching patient, and changes in medication concentration during extended operation. With a large volume nebulizer, aerosols can be delivered to the patient without dilution via a standard open mask for up to eight hours without refill. The pneumatic HEART nebulizer with 240 mL reservoir was evaluated.
The nebulizer was operated from a single compressed air or oxygen source and found to provide from 10 to 15 L/min of aerosol with 38 to 50 microL of aerosolized medicine per liter of air (or oxygen) and utilize from 30 to 56 mL/hour of medicinal liquid. The mass median aerodynamic diameter of the aerosol droplets was found to be about 2.0 microm (sigma(g) = 2.7). Delivery efficiency to the patient mask was about 90%. The aerosolized medicine delivered to the patient can be increased by adjusting the flow rate of the gas source or changing the solution concentration of medicine. Typically, several milligrams of drug can be delivered to the patient as inhaled aerosol per hour of treatment of which about one-quarter can be expected to be deposited in the lungs. During eight hours of operation the concentration of medicinal solution increased by about a factor of two because of water evaporation.
Continuous nebulization therapy is an important means of treating patients with severe asthma. Dosage criteria can be established based on the operating characteristics of the nebulizer system, drug solution concentration, and patient respiration.
多项研究已证明持续雾化治疗对向重度哮喘和/或即将发生呼吸衰竭的患者输送β2激动剂（如硫酸特布他林或硫酸沙丁胺醇）气雾剂的益处。
本研究的目的是阐明与使用雾化器进行延长时间的气雾剂呼吸治疗相关的操作因素，包括那些影响规定气雾剂剂量的因素以及在治疗条件下与实际输送到患者肺部呼吸道的规定药物之间的关系。
已对使用长时间运行的雾化器进行持续雾化治疗的操作特性和方法进行了研究。考虑的因素有粒径分布、设置条件、雾化浓度和速率、到达患者的气雾剂递送分数以及延长操作期间药物浓度的变化。使用大容量雾化器时，气雾剂可通过标准开放式面罩在不稀释的情况下输送给患者长达8小时而无需重新填充。对具有240 mL储液器的气动HEART雾化器进行了评估。
该雾化器由单一压缩空气或氧气源操作，发现可提供10至15 L/分钟的气雾剂，每升空气（或氧气）含有38至50微升雾化药物，并每小时使用30至56 mL药液。发现气雾剂液滴的质量中值空气动力学直径约为2.0微米（几何标准差=2.7）。向患者面罩的递送效率约为90%。通过调节气体源流速或改变药物溶液浓度可增加输送给患者的雾化药物量。通常，每小时治疗可向患者输送数毫克药物作为吸入气雾剂，其中约四分之一预计会沉积在肺部。在8小时的操作过程中，由于水蒸发，药液浓度增加了约两倍。
持续雾化治疗是治疗重度哮喘患者的重要手段。可根据雾化器系统的操作特性、药物溶液浓度和患者呼吸来制定剂量标准。
