Pressurized aerosol versus jet aerosol delivery to mechanically ventilated patients. Comparison of dose to the lungs

Am Rev Respir Dis. 1990 Feb;141(2):440-4. doi: 10.1164/ajrccm/141.2.440.


The purpose of this study was to compare deposition of aerosol to the lung from a metered-dose inhaler (MDI) and aerosol holding chamber and from a jet nebulizer in ventilator-dependent patients. Twenty-one patients were entered into the study, all receiving assisted ventilation and inhaled bronchodilators because of airflow limitation. The average age was 68 yr; there were 10 men and 11 women. The patients were randomized to receive either 4 puffs (800 micrograms) of radiolabeled fenoterol by MDI of 1.75 ml (1,750 micrograms) of radiolabeled fenoterol solution by nebulizer. Imaging of lung fields was made by a portable scintillation camera at 5-min intervals during the study. Results showed that 20 patients completed the study, 9 receiving fenoterol by MDI, and 11 by jet nebulizer. Four were excluded from analysis because of previous pneumonectomy, two from each group. Lung deposition measured as a percent of given dose from either system was 5.65 +/- 1.09 (mean +/- SEM) for MDI plus extension chamber and 1.22 +/- 0.35 for jet nebulizer (p less than 0.001). Therefore, this trial shows significantly greater efficiency of aerosol deposition to the lung in ventilator-dependent patients when using an MDI plus aerosol holding chamber than when using a jet nebulizer.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aerosols
  • Aged
  • Dose-Response Relationship, Drug
  • Equipment Design
  • Female
  • Fenoterol / administration & dosage
  • Humans
  • Intermittent Positive-Pressure Ventilation / instrumentation*
  • Lung / diagnostic imaging
  • Male
  • Nebulizers and Vaporizers*
  • Positive-Pressure Respiration / instrumentation*
  • Radionuclide Imaging
  • Randomized Controlled Trials as Topic
  • Sodium Pertechnetate Tc 99m
  • Technetium Tc 99m Sulfur Colloid


  • Aerosols
  • Fenoterol
  • Technetium Tc 99m Sulfur Colloid
  • Sodium Pertechnetate Tc 99m