Vibrating membrane devices deliver aerosols more efficient than standard devices: a study in a neonatal upper airway model

J Aerosol Med Pulm Drug Deliv. 2013 Oct;26(5):280-6. doi: 10.1089/jamp.2012.0993. Epub 2012 Dec 28.


Background: Aerosol therapy in preterm infants is challenging, as a very small proportion of the drug deposits in the lungs.

Aim: Our aim was to compare efficiency of standard devices with newer, more efficient aerosol delivery devices.

Methods: Using salbutamol as a drug marker, we studied two prototypes of the investigational eFlow(®) nebulizer for babies (PARI Pharma GmbH), a jet nebulizer (Intersurgical(®) Cirrus(®)), and a pressurized metered dose inhaler (pMDI; GSK) with a detergent-coated holding chamber (AeroChamber(®) MV) in the premature infant nose throat-model (PrINT-model) of a 32-week preterm infant (1,750 g). A filter or an impactor was placed below the infant model's "trachea" to capture the drug dose or particle size, respectively, that would have been deposited in the lung.

Results: Lung dose (percentage of nominal dose) was 1.5%, 6.8%, and 18.0-20.6% for the jet nebulizer, pMDI-holding chamber, and investigational eFlow nebulizers, respectively (p<0.001). Jet nebulizer residue was 69.4% and 10.7-13.9% for the investigational eFlow nebulizers (p<0.001). Adding an elbow extension between the eFlow and the model significantly lowered lung dose (p<0.001). A breathing pattern with lower tidal volume decreased deposition in the PrINT-model and device residue (p<0.05), but did not decrease lung dose.

Conclusions: In a model for infant aerosol inhalation, we confirmed low lung dose using jet nebulizers and pMDI-holding chambers, whereas newer, more specialized vibrating membrane devices, designed specifically for use in preterm infants, deliver up to 20 times more drug to the infant's lung.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Aerosols
  • Albuterol / administration & dosage*
  • Albuterol / pharmacokinetics
  • Drug Delivery Systems*
  • Equipment Design
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Lung / metabolism*
  • Metered Dose Inhalers
  • Models, Anatomic
  • Nebulizers and Vaporizers*
  • Particle Size
  • Tidal Volume
  • Vibration


  • Aerosols
  • Albuterol