Skip to main content
Erschienen in: Intensive Care Medicine 9/2008

01.09.2008 | Experimental

Comparison of lung tissue concentrations of nebulized ceftazidime in ventilated piglets: ultrasonic versus vibrating plate nebulizers

verfasst von: Fabio Ferrari, Zhi-Hai Liu, Qin Lu, Marie-Helene Becquemin, Kamel Louchahi, Guy Aymard, Charles-Hugo Marquette, Jean-Jacques Rouby

Erschienen in: Intensive Care Medicine | Ausgabe 9/2008

Einloggen, um Zugang zu erhalten

Abstract

Objective

To compare the efficiency of an Aeroneb Pro vibrating plate and an Atomisor MegaHertz ultrasonic nebulizer for providing ceftazidime distal lung deposition.

Design

In vitro experiments. One gram of cetazidime was nebulized in respiratory circuits and mass median aerodynamic diameter of particles generated by ultrasonic and vibrating plate nebulizers was compared using a laser velocimeter. In vivo experiments. Lung tissue concentrations and extrapulmonary depositions were measured in ten anesthetized ventilated piglets with healthy lungs that received 1 g of ceftazidime by nebulization with either an ultrasonic (n = 5), or a vibrating plate (n = 5) nebulizer.

Setting

A two-bed Experimental Intensive Care Unit of a University School of Medicine.

Intervention

Following sacrifice, 5 subpleural specimens were sampled in dependent and nondependent lung regions for measuring ceftazidime lung tissue concentrations by high-performance liquid chromatography.

Measurements and results

Mass median aerodynamic diameters generated by both nebulizers were similar with more than 95% of the particles between 0.5 and 5 μm. Lung tissue concentrations were 553 ± 123 [95% confidence interval: 514–638] μg g−1 using ultrasonic nebulizer, and 452 ± 172 [95% confidence interval: 376–528] μg g−1 using vibrating plate nebulizers (NS). Extrapulmonary depositions were, respectively, of 38 ± 5% (ultrasonic) and 34 ± 4% (vibrating plate) (NS).

Conclusions

Vibrating plate nebulizer is comparable to ultrasonic nebulizers for ceftazidime nebulization. It may represent a new attractive technology for inhaled antibiotic therapy.
Literatur
1.
Zurück zum Zitat O’Riordan TG, Palmer LB, Smaldone GC (1994) Aerosol deposition in mechanically ventilated patients. Optimizing nebulizer delivery. Am J Respir Crit Care Med 149:214–219PubMed O’Riordan TG, Palmer LB, Smaldone GC (1994) Aerosol deposition in mechanically ventilated patients. Optimizing nebulizer delivery. Am J Respir Crit Care Med 149:214–219PubMed
2.
Zurück zum Zitat Dhand R, Mercier E (2007) Effective inhaled drug administration to mechanically ventilated patients. Expert Opin Drug Deliv 4:47–61PubMedCrossRef Dhand R, Mercier E (2007) Effective inhaled drug administration to mechanically ventilated patients. Expert Opin Drug Deliv 4:47–61PubMedCrossRef
3.
Zurück zum Zitat Rouby JJ, Goldstein I, Lu Q (2006) Inhaled antibiotic therapy. In: Tobin MJ (ed) Principles and practice of mechanical ventilation. McGraw-Hill Medical Publishing Division, New York, pp 1311–1332 Chapter 64 Rouby JJ, Goldstein I, Lu Q (2006) Inhaled antibiotic therapy. In: Tobin MJ (ed) Principles and practice of mechanical ventilation. McGraw-Hill Medical Publishing Division, New York, pp 1311–1332 Chapter 64
4.
Zurück zum Zitat Harvey CJ, O’Doherty MJ, Page CJ, Thomas SH, Nunan TO, Treacher DF (1997) Comparison of jet and ultrasonic nebulizer pulmonary aerosol deposition during mechanical ventilation. Eur Respir J 10:905–909PubMed Harvey CJ, O’Doherty MJ, Page CJ, Thomas SH, Nunan TO, Treacher DF (1997) Comparison of jet and ultrasonic nebulizer pulmonary aerosol deposition during mechanical ventilation. Eur Respir J 10:905–909PubMed
5.
Zurück zum Zitat Dubus JC, Vecellio L, De Monte M, Fink JB, Grimbert D, Montharu J, Valat C, Behan N, Diot P (2005) Aerosol deposition in neonatal ventilation. Pediatr Res 58:10–14PubMedCrossRef Dubus JC, Vecellio L, De Monte M, Fink JB, Grimbert D, Montharu J, Valat C, Behan N, Diot P (2005) Aerosol deposition in neonatal ventilation. Pediatr Res 58:10–14PubMedCrossRef
6.
Zurück zum Zitat Bressolle F, de la Coussaye JE, Ayoub R, Fabre D, Gomeni R, Saissi G, Eledjam JJ, Galtier M (1992) Endotracheal and aerosol administrations of ceftazidime in patients with nosocomial pneumonia: pharmacokinetics and absolute bioavailability. Antimicrob Agents Chemother 36:1404–1411PubMed Bressolle F, de la Coussaye JE, Ayoub R, Fabre D, Gomeni R, Saissi G, Eledjam JJ, Galtier M (1992) Endotracheal and aerosol administrations of ceftazidime in patients with nosocomial pneumonia: pharmacokinetics and absolute bioavailability. Antimicrob Agents Chemother 36:1404–1411PubMed
7.
Zurück zum Zitat Goldstein I, Wallet F, Nicolas-Robin A, Ferrari F, Marquette CH, Rouby JJ (2002) Lung deposition and efficiency of nebulized amikacin during Escherichia coli pneumonia in ventilated piglets. Am J Respir Crit Care Med 166:1375–1381PubMedCrossRef Goldstein I, Wallet F, Nicolas-Robin A, Ferrari F, Marquette CH, Rouby JJ (2002) Lung deposition and efficiency of nebulized amikacin during Escherichia coli pneumonia in ventilated piglets. Am J Respir Crit Care Med 166:1375–1381PubMedCrossRef
8.
Zurück zum Zitat Tonnellier M, Ferrari F, Goldstein I, Sartorius A, Marquette CH, Rouby JJ (2005) Intravenous versus nebulized ceftazidime in ventilated piglets with and without experimental bronchopneumonia: comparative effects of helium and nitrogen. Anesthesiology 102:995–1000PubMedCrossRef Tonnellier M, Ferrari F, Goldstein I, Sartorius A, Marquette CH, Rouby JJ (2005) Intravenous versus nebulized ceftazidime in ventilated piglets with and without experimental bronchopneumonia: comparative effects of helium and nitrogen. Anesthesiology 102:995–1000PubMedCrossRef
9.
Zurück zum Zitat Elman M, Goldstein I, Marquette CH, Wallet F, Lenaour G, Rouby JJ (2002) Influence of lung aeration on pulmonary concentrations of nebulized and intravenous amikacin in ventilated piglets with severe bronchopneumonia. Anesthesiology 97:199–206PubMedCrossRef Elman M, Goldstein I, Marquette CH, Wallet F, Lenaour G, Rouby JJ (2002) Influence of lung aeration on pulmonary concentrations of nebulized and intravenous amikacin in ventilated piglets with severe bronchopneumonia. Anesthesiology 97:199–206PubMedCrossRef
10.
Zurück zum Zitat Miller DD, Amin MM, Palmer LB, Shah AR, Smaldone GC (2003) Aerosol delivery and modern mechanical ventilation: in vitro/in vivo evaluation. Am J Respir Crit Care Med 168:1205–1209PubMedCrossRef Miller DD, Amin MM, Palmer LB, Shah AR, Smaldone GC (2003) Aerosol delivery and modern mechanical ventilation: in vitro/in vivo evaluation. Am J Respir Crit Care Med 168:1205–1209PubMedCrossRef
11.
Zurück zum Zitat Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, Moher D, Rennie D, de Vet HC, Lijmer JG (2003) The STARD statement for reporting studies of diagnostic accuracy: explanation and elaboration. Ann Intern Med 138:W1–W12PubMed Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, Moher D, Rennie D, de Vet HC, Lijmer JG (2003) The STARD statement for reporting studies of diagnostic accuracy: explanation and elaboration. Ann Intern Med 138:W1–W12PubMed
12.
Zurück zum Zitat Goldstein I, Wallet F, Robert J, Becquemin MH, Marquette CH, Rouby JJ (2002) Lung tissue concentrations of nebulized amikacin during mechanical ventilation in piglets with healthy lungs. Am J Respir Crit Care Med 165:171–175PubMed Goldstein I, Wallet F, Robert J, Becquemin MH, Marquette CH, Rouby JJ (2002) Lung tissue concentrations of nebulized amikacin during mechanical ventilation in piglets with healthy lungs. Am J Respir Crit Care Med 165:171–175PubMed
13.
Zurück zum Zitat Faurisson F, Dessanges JF, Grimfeld A, Beaulieu R, Kitzis MD, Peytavin G, Lefevre JP, Farinotti R, Sautegeau A (1996) Comparative study of the performance and ergonomics of nebulizers in cystic fibrosis. Rev Mal Respir 13:155–162PubMed Faurisson F, Dessanges JF, Grimfeld A, Beaulieu R, Kitzis MD, Peytavin G, Lefevre JP, Farinotti R, Sautegeau A (1996) Comparative study of the performance and ergonomics of nebulizers in cystic fibrosis. Rev Mal Respir 13:155–162PubMed
14.
Zurück zum Zitat Pedersen KM, Handlos VN, Heslet L, Kristensen HG (2006) Factors influencing the in vitro deposition of tobramycin aerosol: a comparison of an ultrasonic nebulizer and a high-frequency vibrating mesh nebulizer. J Aerosol Med 19:175–183PubMedCrossRef Pedersen KM, Handlos VN, Heslet L, Kristensen HG (2006) Factors influencing the in vitro deposition of tobramycin aerosol: a comparison of an ultrasonic nebulizer and a high-frequency vibrating mesh nebulizer. J Aerosol Med 19:175–183PubMedCrossRef
15.
Zurück zum Zitat O’Riordan TG, Amram JC (1997) Effect of nebulizer configuration on delivery of aerosolized tobramycin. J Aerosol Med 10:13–23PubMedCrossRef O’Riordan TG, Amram JC (1997) Effect of nebulizer configuration on delivery of aerosolized tobramycin. J Aerosol Med 10:13–23PubMedCrossRef
16.
Zurück zum Zitat Fink JB, Dhand R, Grychowski J, Fahey PJ, Tobin MJ (1999) Reconciling in vitro and in vivo measurements of aerosol delivery from a metered-dose inhaler during mechanical ventilation and defining efficiency-enhancing factors. Am J Respir Crit Care Med 159:63–68PubMed Fink JB, Dhand R, Grychowski J, Fahey PJ, Tobin MJ (1999) Reconciling in vitro and in vivo measurements of aerosol delivery from a metered-dose inhaler during mechanical ventilation and defining efficiency-enhancing factors. Am J Respir Crit Care Med 159:63–68PubMed
17.
Zurück zum Zitat Jandre FC, Carvalho AR, Pino AV, Giannella-Neto A (2005) Effects of filtering and delays on the estimates of a nonlinear respiratory mechanics model. Respir Physiol Neurobiol 148:309–314PubMedCrossRef Jandre FC, Carvalho AR, Pino AV, Giannella-Neto A (2005) Effects of filtering and delays on the estimates of a nonlinear respiratory mechanics model. Respir Physiol Neurobiol 148:309–314PubMedCrossRef
18.
Zurück zum Zitat Goode ML, Fink JB, Dhand R, Tobin MJ (2001) Improvement in aerosol delivery with helium–oxygen mixtures during mechanical ventilation. Am J Respir Crit Care Med 163:109–114PubMed Goode ML, Fink JB, Dhand R, Tobin MJ (2001) Improvement in aerosol delivery with helium–oxygen mixtures during mechanical ventilation. Am J Respir Crit Care Med 163:109–114PubMed
19.
Zurück zum Zitat Dhand R (2002) Nebulizers that use a vibrating mesh or plate with multiple apertures to generate aerosol. Respir Care 47:1406–1416; discussion 1416–1408PubMed Dhand R (2002) Nebulizers that use a vibrating mesh or plate with multiple apertures to generate aerosol. Respir Care 47:1406–1416; discussion 1416–1408PubMed
20.
Zurück zum Zitat Sartorius A, Lu Q, Vieira S, Tonnellier M, Lenaour G, Goldstein I, Rouby JJ (2007) Mechanical ventilation and lung infection in the genesis of air-space enlargement. Crit Care 11:R14PubMedCrossRef Sartorius A, Lu Q, Vieira S, Tonnellier M, Lenaour G, Goldstein I, Rouby JJ (2007) Mechanical ventilation and lung infection in the genesis of air-space enlargement. Crit Care 11:R14PubMedCrossRef
Metadaten
Titel
Comparison of lung tissue concentrations of nebulized ceftazidime in ventilated piglets: ultrasonic versus vibrating plate nebulizers
verfasst von
Fabio Ferrari
Zhi-Hai Liu
Qin Lu
Marie-Helene Becquemin
Kamel Louchahi
Guy Aymard
Charles-Hugo Marquette
Jean-Jacques Rouby
Publikationsdatum
01.09.2008
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 9/2008
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-008-1126-4

Weitere Artikel der Ausgabe 9/2008

Intensive Care Medicine 9/2008 Zur Ausgabe

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.