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

• Published in: Pharmaceutical research Vol. 34; no. 2; pp. 290 - 300
• Main Authors: Dugernier, Jonathan, Hesse, Michel, Vanbever, Rita, Depoortere, Virginie, Roeseler, Jean, Michotte, Jean-Bernard, Laterre, Pierre-François, Jamar, François, Reychler, Gregory
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.02.2017; Springer; Springer Nature B.V
• Subjects: Administration, Inhalation; Adult; Aerosols; Aerosols - administration & dosage; Aerosols - chemistry; Aerosols - metabolism; Biochemistry; Biomedical and Life Sciences; Biomedical Engineering and Bioengineering; Biomedicine; Comparative analysis; Cross-Over Studies; CT imaging; Drug delivery systems; Drug Delivery Systems - methods; Equipment Design - methods; Healthy Volunteers; Humans; Inhalation Spacers; Lung - metabolism; Lungs; Male; Medical equipment; Medical Law; Nebulizers and Vaporizers; Particle Size; Pharmacology/Toxicology; Pharmacy; Prostheses and Implants; Research Paper; Respiratory therapy; SPECT imaging; Technetium - chemistry; Technetium - metabolism; Technetium Tc 99m Pentetate - chemistry; Technetium Tc 99m Pentetate - metabolism; Tomography, Emission-Computed, Single-Photon - methods; Tomography, X-Ray Computed - methods; Valves; Healthy subjects; Single photon emission computed tomography; Aerosol delivery; Spacer; Vibrating-mesh nebulizer
• ISSN: 0724-8741; 1573-904X
• DOI: 10.1007/s11095-016-2061-7

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 ( 99m Tc-DTPA, 2 mCi/4 mL). Pulmonary deposition of 99m 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.