Inadequate Functioning of Nebulizer System Compressors Used by Individuals With Cystic Fibrosis

Abstract

BACKGROUND: The treatment of cystic fibrosis involves the use of drugs delivered by nebulizer systems, and adequate functioning of the compressors and nebulizers is essential. We hypothesized that compressors of nebulizer systems used by individuals with cystic fibrosis would not work properly. Therefore, we aimed to assess the performance of the compressors from nebulizer systems used by individuals with cystic fibrosis. METHODS: This is a cross-sectional study to assess the performance of compressors from nebulizer systems used by subjects with cystic fibrosis registered at the Cystic Fibrosis Patient Association in Minas Gerais, Brazil. Compressors (Proneb Ultra II) brought by the individuals were tested with new nebulizer parts (Pari LC plus) to assess the variables of nebulization efficiency, including residual volume, solution output, and aerosol output rate. Compression performance was assessed by measuring the operating pressure using a PARI PG101 manometer. RESULTS: The performance of 146 compressors was analyzed. Fifty-seven (39%) of the compressors were ineffective, with operating pressure values well below the manufacturer's technical reference and the compressor time used for a median time of 36 (15 days to 156 months). The systems with low pressure values demonstrated significantly worse results for nebulization efficiency variables, and a significant correlation was found between residual volume (r = -0.5, P < .001), solution output (r = +0.5, P < .001), and aerosol output rate (r = +0.5, P < .001), and operating pressure values. CONCLUSIONS: A significant number of compressors generate low operating pressure values. These systems showed a compromised efficiency of nebulization, indicating that the pressure generated by the compressor is a critical aspect of treatment efficiency.