Intensive Care Medicine

, 34:1718 | Cite as

Comparison of lung tissue concentrations of nebulized ceftazidime in ventilated piglets: ultrasonic versus vibrating plate nebulizers

  • Fabio Ferrari
  • Zhi-Hai Liu
  • Qin LuEmail author
  • Marie-Helene Becquemin
  • Kamel Louchahi
  • Guy Aymard
  • Charles-Hugo Marquette
  • Jean-Jacques Rouby



To compare the efficiency of an Aeroneb Pro vibrating plate and an Atomisor MegaHertz ultrasonic nebulizer for providing ceftazidime distal lung deposition.


In vitro experiments. One gram of cetazidime was nebulized in respiratory circuits and mass median aerodynamic diameter of particles generated by ultrasonic and vibrating plate nebulizers was compared using a laser velocimeter. In vivo experiments. Lung tissue concentrations and extrapulmonary depositions were measured in ten anesthetized ventilated piglets with healthy lungs that received 1 g of ceftazidime by nebulization with either an ultrasonic (n = 5), or a vibrating plate (n = 5) nebulizer.


A two-bed Experimental Intensive Care Unit of a University School of Medicine.


Following sacrifice, 5 subpleural specimens were sampled in dependent and nondependent lung regions for measuring ceftazidime lung tissue concentrations by high-performance liquid chromatography.

Measurements and results

Mass median aerodynamic diameters generated by both nebulizers were similar with more than 95% of the particles between 0.5 and 5 μm. Lung tissue concentrations were 553 ± 123 [95% confidence interval: 514–638] μg g−1 using ultrasonic nebulizer, and 452 ± 172 [95% confidence interval: 376–528] μg g−1 using vibrating plate nebulizers (NS). Extrapulmonary depositions were, respectively, of 38 ± 5% (ultrasonic) and 34 ± 4% (vibrating plate) (NS).


Vibrating plate nebulizer is comparable to ultrasonic nebulizers for ceftazidime nebulization. It may represent a new attractive technology for inhaled antibiotic therapy.


Ultrasonic Vibrating plate Nebulizer Nebulization of antibiotics Lung tissue concentration 



The authors thank Benoît Lecuelle, Arnold Dive and Michel Pottier, Département Hospitalo-Universitaire de Recherche Expérimentale and INSERM U 416 of Institut Pasteur, University of Lille, France for the preparation of the animals.


  1. 1.
    O’Riordan TG, Palmer LB, Smaldone GC (1994) Aerosol deposition in mechanically ventilated patients. Optimizing nebulizer delivery. Am J Respir Crit Care Med 149:214–219PubMedGoogle Scholar
  2. 2.
    Dhand R, Mercier E (2007) Effective inhaled drug administration to mechanically ventilated patients. Expert Opin Drug Deliv 4:47–61PubMedCrossRefGoogle Scholar
  3. 3.
    Rouby JJ, Goldstein I, Lu Q (2006) Inhaled antibiotic therapy. In: Tobin MJ (ed) Principles and practice of mechanical ventilation. McGraw-Hill Medical Publishing Division, New York, pp 1311–1332 Chapter 64Google Scholar
  4. 4.
    Harvey CJ, O’Doherty MJ, Page CJ, Thomas SH, Nunan TO, Treacher DF (1997) Comparison of jet and ultrasonic nebulizer pulmonary aerosol deposition during mechanical ventilation. Eur Respir J 10:905–909PubMedGoogle Scholar
  5. 5.
    Dubus JC, Vecellio L, De Monte M, Fink JB, Grimbert D, Montharu J, Valat C, Behan N, Diot P (2005) Aerosol deposition in neonatal ventilation. Pediatr Res 58:10–14PubMedCrossRefGoogle Scholar
  6. 6.
    Bressolle F, de la Coussaye JE, Ayoub R, Fabre D, Gomeni R, Saissi G, Eledjam JJ, Galtier M (1992) Endotracheal and aerosol administrations of ceftazidime in patients with nosocomial pneumonia: pharmacokinetics and absolute bioavailability. Antimicrob Agents Chemother 36:1404–1411PubMedGoogle Scholar
  7. 7.
    Goldstein I, Wallet F, Nicolas-Robin A, Ferrari F, Marquette CH, Rouby JJ (2002) Lung deposition and efficiency of nebulized amikacin during Escherichia coli pneumonia in ventilated piglets. Am J Respir Crit Care Med 166:1375–1381PubMedCrossRefGoogle Scholar
  8. 8.
    Tonnellier M, Ferrari F, Goldstein I, Sartorius A, Marquette CH, Rouby JJ (2005) Intravenous versus nebulized ceftazidime in ventilated piglets with and without experimental bronchopneumonia: comparative effects of helium and nitrogen. Anesthesiology 102:995–1000PubMedCrossRefGoogle Scholar
  9. 9.
    Elman M, Goldstein I, Marquette CH, Wallet F, Lenaour G, Rouby JJ (2002) Influence of lung aeration on pulmonary concentrations of nebulized and intravenous amikacin in ventilated piglets with severe bronchopneumonia. Anesthesiology 97:199–206PubMedCrossRefGoogle Scholar
  10. 10.
    Miller DD, Amin MM, Palmer LB, Shah AR, Smaldone GC (2003) Aerosol delivery and modern mechanical ventilation: in vitro/in vivo evaluation. Am J Respir Crit Care Med 168:1205–1209PubMedCrossRefGoogle Scholar
  11. 11.
    Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, Moher D, Rennie D, de Vet HC, Lijmer JG (2003) The STARD statement for reporting studies of diagnostic accuracy: explanation and elaboration. Ann Intern Med 138:W1–W12PubMedGoogle Scholar
  12. 12.
    Goldstein I, Wallet F, Robert J, Becquemin MH, Marquette CH, Rouby JJ (2002) Lung tissue concentrations of nebulized amikacin during mechanical ventilation in piglets with healthy lungs. Am J Respir Crit Care Med 165:171–175PubMedGoogle Scholar
  13. 13.
    Faurisson F, Dessanges JF, Grimfeld A, Beaulieu R, Kitzis MD, Peytavin G, Lefevre JP, Farinotti R, Sautegeau A (1996) Comparative study of the performance and ergonomics of nebulizers in cystic fibrosis. Rev Mal Respir 13:155–162PubMedGoogle Scholar
  14. 14.
    Pedersen KM, Handlos VN, Heslet L, Kristensen HG (2006) Factors influencing the in vitro deposition of tobramycin aerosol: a comparison of an ultrasonic nebulizer and a high-frequency vibrating mesh nebulizer. J Aerosol Med 19:175–183PubMedCrossRefGoogle Scholar
  15. 15.
    O’Riordan TG, Amram JC (1997) Effect of nebulizer configuration on delivery of aerosolized tobramycin. J Aerosol Med 10:13–23PubMedCrossRefGoogle Scholar
  16. 16.
    Fink JB, Dhand R, Grychowski J, Fahey PJ, Tobin MJ (1999) Reconciling in vitro and in vivo measurements of aerosol delivery from a metered-dose inhaler during mechanical ventilation and defining efficiency-enhancing factors. Am J Respir Crit Care Med 159:63–68PubMedGoogle Scholar
  17. 17.
    Jandre FC, Carvalho AR, Pino AV, Giannella-Neto A (2005) Effects of filtering and delays on the estimates of a nonlinear respiratory mechanics model. Respir Physiol Neurobiol 148:309–314PubMedCrossRefGoogle Scholar
  18. 18.
    Goode ML, Fink JB, Dhand R, Tobin MJ (2001) Improvement in aerosol delivery with helium–oxygen mixtures during mechanical ventilation. Am J Respir Crit Care Med 163:109–114PubMedGoogle Scholar
  19. 19.
    Dhand R (2002) Nebulizers that use a vibrating mesh or plate with multiple apertures to generate aerosol. Respir Care 47:1406–1416; discussion 1416–1408PubMedGoogle Scholar
  20. 20.
    Sartorius A, Lu Q, Vieira S, Tonnellier M, Lenaour G, Goldstein I, Rouby JJ (2007) Mechanical ventilation and lung infection in the genesis of air-space enlargement. Crit Care 11:R14PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Fabio Ferrari
    • 1
  • Zhi-Hai Liu
    • 2
  • Qin Lu
    • 3
    • 8
    Email author
  • Marie-Helene Becquemin
    • 4
  • Kamel Louchahi
    • 5
  • Guy Aymard
    • 6
  • Charles-Hugo Marquette
    • 7
  • Jean-Jacques Rouby
    • 3
  1. 1.Department of AnesthesiologyFaculdade de Medicina da Universidade Estadual Paulista Julio de Mesquita FilhoBotucatuBrazil
  2. 2.Department of Emergency Medicine, School of MedicineSecond Affiliated Hospital, Zhejiang UniversityHangzhouChina
  3. 3.Surgical Intensive Care Unit Pierre Viars, Department of Anesthesiology and Critical Care MedicineAssistance Publique–Hôpitaux de Paris, La Pitié-Salpêtrière Hospital, University of Paris-6ParisFrance
  4. 4.Department of Respiratory PhysiologyAssistance Publique–Hôpitaux de Paris, La Pitié-Salpêtrière Hospital, Denis Diderot UniversityParisFrance
  5. 5.Department of PharmacologyAssistance Publique-Hôpitaux de Paris, Avicenne HospitalBobignyFrance
  6. 6.Department of PharmacologyAssistance Publique–Hôpitaux de Paris, La Pitié-Salpêtrière HospitalParisFrance
  7. 7.Département Hospitalo-Universitaire de Recherche Expérimentale and INSERM U 416 of Institut PasteurUniversirty of LilleLilleFrance
  8. 8.Réanimation Chirurgicale Polyvalente Pierre Viars, Department of Anesthesiology and Critical CareLa Pitié-Salpêtrière HospitalParisFrance

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