Nebulization of a suspension of budesonide and a solution of terbutaline into a neonatal ventilator circuit

Respir Care. 2001 Jan;46(1):43-8.


Methods: The amount of nebulized budesonide and terbutaline delivered through an endotracheal tube (ETT) was measured in vitro using a test lung and filters in a neonatal ventilator circuit. Budesonide suspension (1 mg) was used in a concentration of 0.5 mg/mL and terbutaline solution (5 mg) in a concentration of 2.5 mg/mL.

Results: The median amount of terbutaline deposited on the inspiratory filters was significantly higher than that of budesonide: 0.4% vs 0.3% of the nominal doses with the nebulizer connected 8 cm upstream of the ETT and nebulization performed in a constant output mode (setup A), and 2.8% vs 1.0% with the nebulizer connected directly to the ETT and nebulization performed in a breath-synchronized mode (setup B) (p < 0.05 for both). The corresponding amounts of drug deposited on the waste filters with setup A were 19.2% for terbutaline and 12.6% for budesonide, and with setup B 16.2% for terbutaline and 6.2% for budesonide (p < 0.05 for both).

Conclusions: The ratio between drug delivery to the inspiratory and waste filters, describing the relationship between lung deposition and wastage of drug to the ventilator circuit, was setup-dependent but not drug-dependent. The ratio with setup A was 0.02 for both budesonide and terbutaline. The respective ratios were significantly (p < 0.05) higher for budesonide (0.16) and for terbutaline (0.17) with setup B. The differences in the delivered doses of the two drugs through the ETT seems to be a function of both the drug formulation and the nebulizer-ETT setup. With the nebulizer connected directly to the ETT and nebulization in breath-synchronized mode, the differences between the two drugs were enhanced, compared with the nebulizer connected upstream of the ETT and nebulization in constant output mode. The results indicate that a solution is superior to a suspension in terms of drug delivery through an ETT.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aerosols
  • Bronchodilator Agents / administration & dosage*
  • Budesonide / administration & dosage*
  • Humans
  • Infant, Newborn
  • Infant, Premature, Diseases / drug therapy
  • Intubation, Intratracheal*
  • Lung Diseases / drug therapy
  • Models, Structural
  • Nebulizers and Vaporizers
  • Solutions
  • Suspensions
  • Terbutaline / administration & dosage*
  • Ventilators, Mechanical*


  • Aerosols
  • Bronchodilator Agents
  • Solutions
  • Suspensions
  • Budesonide
  • Terbutaline