Development of low-cost portable ultrasonic nebulizer in COVID 19 Era : DIY nano nebulizer

Respiratory diseases are major public health problem in resource poor countries. This global problem greatly accentuated in the COVID 19 pandemic, which results in shortage of resources. Nebulized therapy is the recommended therapy for the patients with respiratory diseases with or without COVID 19. Jet nebulizers are bulky and ultrasonic are expensive. Therefore we are describing novel, simple, inexpensive, DIY – Nano nebulizer which can be use a homemade solution without the need of specific equipment.

Particle Dynamics and Bioaerosol Viability of Aerosolized BCG Vaccine Using Jet and Vibrating Mesh Clinical Nebulizers

BackgroundBacillus Calmette–Guérin (BCG) is a vaccine used to protect against tuberculosis primarily in infants to stop early infection in areas of the world where the disease is endemic. Normally administered as a percutaneous injection, BCG is a live, significantly attenuated bacteria that is now being investigated for its potential within an inhalable vaccine formulation. This work investigates the feasibility and performance of four jet and ultrasonic nebulizers aerosolizing BCG and the resulting particle characteristics and residual viability of the bacteria post-aerosolization.MethodsA jet nebulizer (Collison) outfitted either with a 3- or 6-jet head, was compared to two clinical nebulizers, the vibrating mesh Omron MicroAir and Aerogen Solo devices. Particle characteristics, including aerodynamic particle sizing, was performed on all devices within a common aerosol chamber configuration and comparable BCG innocula concentrations. Integrated aerosol samples were collected for each generator and assayed for bacterial viability using conventional microbiological technique.Results and ConclusionsA batch lot of BCG (Danish) was grown to titer and used in all generator assessments. Aerosol particles within the respirable range were generated from all nebulizers at four different concentrations of BCG. The jet nebulizers produced a uniformly smaller particle size than the ultrasonic devices, although particle concentrations by mass were similar across all devices tested with the exception of the Aerogen Solo, which resulted in a very low concentration of BCG aerosols. The resulting measured viable BCG aerosol concentration fraction produced by each device approximated one another; however, a measurable decrease of efficiency and overall viability reduction in the jet nebulizer was observed in higher BCG inoculum starting concentrations, whereas the vibrating mesh nebulizer returned a remarkably stable viable aerosol fraction irrespective of inoculum concentration.

Degradation of lipid based drug delivery formulations during nebulization

Encapsulating pharmaceuticals in protective lipid based nanoparticles, and nebulizing them towards the target area in the body offers a range of clinical advantages. However, the process of nebulization might possibly damage sensitive nanoparticle structures, such as liposomes, resulting in loss of active pharmaceutical ingredients. We compare this loss for two types of lung inhalation devices: high-frequency piezo-actuated vibrating mesh nebulizers and non-actuated continuous jet nebulizers. We find that vibrating mesh nebulizers cause model liposomes to release more than ten times as much encapsulated material as the continuous jet nebulizers because the energies involved in nebulization are much larger. This result highlights the importance of applying a mild nebulization technology when administering shear-sensitive drug formulations such as lipid nanoparticle based drugs to the lungs.

Рossibilities of clinical application of modern nebulizers

The simplicity of converting medicinal solutions and suspensions into aerosols using mechanical and thermal energy, convenient delivery to the airways allows nebulizers to take a worthy place in the treatment of hospitalized and outpatient patients. Different types of nebulizers are available for use in the home and in medical settings (jet, ultrasound, membrane), and researches show that the performance and characteristics of the aerosol vary between different devices and manufacturers. Jet nebulizers are still the most used devices that do not require coordination of inhale and delivery of aerosol to the respiratory tract. To reduce the consumption of medicinal aerosol and optimize the air flow, virtual valve technology (V.V.T.) is being improved, and breath-actuated nebulizers are being created. The advantage of nebulizer therapy is the ability to apply large doses of medications, use substances that exist only in inhaled form. The choice falls on the nebulizer in cases where the patient can not use other delivery devices, for example, if the patient is unable to coordinate the inhalation and intake of the drug into the respiratory tract, with a severe exacerbation of obstructive disease, in the presence of motor disorders. The optimal delivery device for children of any age, including newborns, is a nebulizer. The most common indication for nebulizer therapy is the delivery of bronchodilators and inhaled corticosteroids for asthma or chronic obstructive pulmonary disease, as well as the treatment of upper respiratory tract diseases, in particular croup in children. An important place is given to nebulizers when it is necessary to prescribe certain mucolytics and antibiotics. In the treatment of emergency conditions, inhalation administration of drugs may be required, including situations when the patient is on mechanical ventilation or has a tracheostomy installed. The significance of nebulizers in the treatment of cystic fibrosis, pulmonary arterial hypertension, and alpha-1-antitrypsin deficiency is being studied. The possibilities of endobronchial delivery of heparin, insulin, and monoclonal antibodies are evaluated.

Aerosol Delivery of Dornase Alfa Generated by Jet and Mesh Nebulizers

Recent reports on mesh nebulizers suggest the possibility of stable nebulization of various therapeutic protein drugs. In this study, the in vitro performance and drug stability of jet and mesh nebulizers were examined for dornase alfa and compared with respect to their lung delivery efficiency in BALB/c mice. We compared four nebulizers: two jet nebulizers (PARI BOY SX with red and blue nozzles), a static mesh nebulizer (NE-U150), and a vibrating mesh nebulizer (NE-SM1). The enzymatic activity of dornase alfa was assessed using a kinetic fluorometric DNase activity assay. Both jet nebulizers had large residual volumes between 24% and 27%, while the volume of the NE-SM1 nebulizer was less than 2%. Evaluation of dornase alfa aerosols produced by the four nebulizers showed no overall loss of enzymatic activity or protein content and no increase in aggregation or degradation. The amount of dornase alfa delivered to the lungs was highest for the PARI BOY SX-red jet nebulizer. This result confirmed that aerosol droplet size is an important factor in determining the efficiency of dornase alfa delivery to the lungs. Further clinical studies and analysis are required before any conclusions can be drawn regarding the clinical safety and efficacy of these nebulizers.

The Presence of Legionellae in Respiratory Devices

Legionella is a bacterium found naturally in moist environments. Persons can become infected when they inhale airborne droplets of water containing such bacteria. Legionellosis cases associated with the use of respiratory devices such as Continuous Positive Airway Pressure (CPAP) units, jet nebulizers, portable room humidifiers, and respiratory ventilation equipment have been identified in context of a Legionellosis outbreak. However, a systematic search for the presence of Legionella bacteria in respiratory devices outside of a Legionellosis outbreak has not been reported. The goal of this study was to carry out such a survey on different types of respiratory devices in long term care facilities. Twenty-four respiratory devices including 9 CPAP, 4 BIPAPs, 5 oxygen humidifiers, and 6 ventilators were included in this study. A total of 72 sampling swabs were obtained for the testing of Legionella bacteria inside the respiratory devices. Culture and PCR tests for Legionella pneumophelia were made in tandem. No legionella pneumophelia bacteria were found in any of the respiratory devices sampled. Although there have been reports in the past of potential legionellosis cases associated with the use of respiratory devices, our data suggest that there are probably no legionella bacteria present inside respiratory devices separate of a Legionellosis outbreak.

Continuous Aerosol Medication Therapy in an in vitro High-Flow System Using Wire Mesh Technology

BACKGROUNDJet nebulizers are commonly used to provide continuous aerosolized medication therapy (CAMT). We observed the function of our CAMT system that utilizes the Aeroneb Solo nebulizer system (Aerogen Ltd, Galway, Ireland). METHODS: An observational study was performed on 2 CAMT systems with 15 Aeroneb nebulizers for each system. CAMT was simulated for 1, 2 and 3 hours. Continuous nebulization was monitored and residual volumes were recorded at the end of each simulation. Our primary endpoint was established as intermittent nebulization observed by nebulizer filling of > 1 ml during CAMT simulation. Secondary endpoint was a residual volume of < 0.1 ml.RESULTSOut of 30 simulations in two arms, a fluid level was observed to accumulate intermittently in three nebulizers with a residual volume of 0.7 mls in one of these three. This produced a total success rate of 90%, Arm-A 80%, Arm B-100%, for our primary endpoint. Our secondary endpoint was achieved in 29 of the 30 nebulizers for an overall 97% success rate, Arm A-93%, Arm B-100%. CONCLUSION: Our Aerogen Solo CAMT system successfully emitted the set dose with 90% accuracy.

Characterization of Aerosol Nebulized by Aerogen Solo Mesh Nebulizer

Nebulizers are commonly used devices for inhalation treatment of various disorders. There are three main categories of medical nebulization technology: jet nebulizers, ultrasound nebulizer, and mesh nebulizer. The mesh nebulizers seem to be very promising since this technology should be able to produce aerosol with precisely determined particle size and is easy to use as well [1]. Aerosol generated from the mesh nebulizer Aerogen Solo was measured in this work. Particle size distribution with a mass median of aerodynamic diameter (MMAD) was determined by two different methods.