Pulmonary deposition of aerosols by different mechanical devices.

With a new method for easy labeling of beta 2-agonists we measured intra- and extrapulmonary aerosol deposition after the administration of a bolus from a metered-dose inhaler at residual volume (RV) inhaling after a pause of 2 s and after immediate administration into the inspiratory flow at functional residual capacity (FRC). Immediate administration during a slow inspiratory vital capacity maneuver gives the highest intrapulmonary deposition (30-40%). Compressed air and ultrasonic nebulizers with a particle distribution pattern of 2-5 micron aerodynamic mass median diameter (AMMD) allow in normal subjects to achieve an intrapulmonary deposition of 30-60% during standardized tidal breathing at rest, the magnitude of the deposition depending mainly on each subject's larynx geometry. The outlet system leads to different deposition patterns in aerosol generators with the same AMMD. Many commercially available aerosol generators do not fulfill the criteria for any intrapulmonary aerosol deposition. For drug administration into the lungs, condensation aerosol generators ('steam boiler nebulizers') are useless as well as compressed-air, ultrasonic and steam driven nebulizers with a particle size of more than 10 micron AMMD.