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Nebulizer delivery of tobramycin to the lower respiratory tract
Author(s) -
Weber Allan,
Smith Arnold,
WilliamsWarren Judy,
Ramsey Bonnie,
Covert David S.
Publication year - 1994
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1950170511
Subject(s) - nebulizer , tobramycin , aerosol , medicine , sputum , respiratory tract , particle size , cystic fibrosis , chromatography , respiratory system , surgery , anesthesia , chemistry , antibiotics , pathology , biochemistry , organic chemistry , tuberculosis , gentamicin
We characterized a tobramycin aerosol generated by five nebulizers: Micron One®, Pulmosonic®, Pulmo‐Aide®, De Vilbiss Model 65®, and Ultra Neb 100® by particle size and drug concentration. The Micron One nebulizer did not produce a recoverable aerosol, while the Pulmosonic had a minimal output: therefore three machines were examined for their ability to deliver tobramycin to the lower respiratory tract of patients with cystic f ibrosis (CF). The De Vilbiss 65 had the greatest output: with air as the carrier gas it produced an aerosol with >60% of the particles having a mean mass aerodynamic diameter (MMAD) of >5.5 μm. Using helox shifted the MMAD so that >65% of the particles were <5.5 μm. Increasing the power in the De Vilbiss 65 increased the output of particles >9.2 μm, without a change in the particles <3.3 μm. With air as the carrier gas the Pulmo‐Aide and the Ultra Neb 100 produced an aerosol with >60% particles, <3.3 μm MMAD. Using helox the Ultra Neb 100 increased the amount of aerosol with a 13.3 μm MMAD to 98%. Tobramycin delivery to the lower respiratory tract with the Pulmo‐Aide and Ultra Neb 100 was compared using air or helox by measuring sputum drug concentration. Pulmo‐Aide failed to produce detectable tobramycin in sputum in 2 out of 9 patients with CF. With the Ultra Neb 100, all patients had measurable sputum tobramycin immediately after administration (range, 16.2–3385 μg/g), but no statistically significant difference was found when using either compressed air, helox, or ambient air. There was no correlation between pulmonary function and sputum tobramycin content. We conclude that the Ultra Neb 100 consistently delivered tobramycin to the lower respiratory tract in patients with CF. Pediatr Pulmonol. 1994; 17:331–339. © 1994 Wiley‐Liss, Inc.