An in vitro comparison of the impact of jet nebulizer design on the aerosol characterization
of commonly used asthma drugs

Respironics Respiratory Drug Delivery, Cedar Grove, NJ, USA Find This Study
The Study
Depending upon design, jet nebulizers are typically classified as conventional (e.g. Salter 8900), active
venturi (e.g. Sidestream®) or breath-enhanced (Pari LC Plus®). Design differences are likely to affect the
characteristics of aerosol delivery. This study presents the results of an in vitro comparison of nebulizer
classifications using three commonly used asthma medications.
Three units of each of the nebulizer brands were randomly selected. An Inspiration Elite compressor was used
throughout. Study drugs: albuterol (2.5 mg, 3 mL), ipratropium bromide (0.5 mg, 2.5 mL) and budesonide
(0.5 mg, 2 mL). For determination of particle size (mass median aerodynamic diameter (MMAD)), respirable
fraction (RD), and delivery rate (DR), the drug-filled nebulizers were connected to an In-Tox cascade
impactor. Tests were run in triplicate and a spectrophotometer technique was used for drug characterization.
The tests were conducted as per FDA guidance (Piper Medical Products, Carmichael, CA).
The Results
The results highlight the impact of nebulizer design on important aerosol drug characteristics when using
standardized testing methodology.
What’s New
The study data documents high quality, efficient aerosolization by Respironics’ Sidestream as compared to the
Pari LC+. For our customers, Sidestream delivers this high quality performance while simultaneously
providing a value-priced alternative to the premium pricing of the LC+. Using FDA guidance test
methodology, Sidestream’s performance is well-aligned to the LC+, while comfortably exceeding that of the
low-end Salter 8900 handset.
Bottom Line
Sidestream’s unique, active-venturi, five jet-hole design, generates a high quality (a high percentage of
respirable particles in the nebulizer output) aerosol that is superior to conventional and competitive with
breath-enhanced designs.
Mass median aerodynamic diameter (MMAD)
MMAD (µm)
Sidestream 2.6 2.5 2.5
Salter 8900

There are no statistically significant differences in the MMAD between the nebulizers for any
of the three drugs.
Respirable Fraction
Respirable Fraction (%)
Sidestream 74.7 72.0 77.0
Salter 8900

There are statistically significant nebulizer dependent differences in respirable fraction in
percent of total drug delivery for albuterol and ipratropium (ANOVA, albuterol p=0.0076;
ipratroprium p=0.0405), but not for budesonide.
Delivery Rate
Delivery Rate (µg/min)
Sidestream 170.4 44.7 46.6
LC+ 159.9
Salter 8900

There are statistically significant nebulizer dependent differences in delivery rates for all
three drugs (ANOVA, albuterol p=0.0083; ipratropium p=0.0457; budesonide p=0.0011).



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