Many sufferers of Bronchial Asthma and COPD need nebuliser therapy in acute conditions.The rotahaler wih rotacaps delivers only 15 to 20% of the drug. Quite a few subjects do not use rotahalers properly inspite of adequate training. In acute exacerbations, their plight is worse. Hence for proper drug delivery in acute conditions, rotacap with rotahaler may not be adequate. Hence an attempt is made for effective delivery of the entire 200mcg salbutamol through a mechanical nebuliser. In the market only electronically operated nebulisers are available.The cost is still prohibitive .Most of the urban and rural areas do not have regular power supply. Even in the hospitals, the nebulisers are far from few. Conamination is a distinct possibility in the wards and ICU settings. There is also lot of wastage in the side stream of electronic nebuliser . It takes atleast 15 to 20 mins for the entire medicine to be nebulised . Hence an Air Pump driven mechanical nebuliser is developed.
Material and Methods : An Air Pump made up of PVC weighing 600gms is fabricated for this device.This has a cylindrical chamber sliding on a steel rod. This has inbuilt posterior and anterior apertures to draw and propel the air out under pressure. There is a pedal mounted on the chamber.The whole unit rests on a metal frame. .There is nylon lining for sliding of the cylinder on the inner axial rod. There is no grease applied for the cylindrical chamber to slide over the axial rod. The anterior end is attached to the nebulising unit, which is availabe in the market. The rotacap containing 200mcg of salbutamol is opened .The nebulising chamber is charged with the salbutamol rotacap powder, dissolving in one to two ml of normal saline. The user connects the mask to face and the other end to the the anterior end of the air pump, which has a nozzle . On pedalling the pump, the mist is released . There is no side stream, avoiding wastage.Thus its a self operating one. If required a helper may pedal the pump.
Results: One hundred adult patients suffering from bronchial asthma were treated with this device, using salbutamol rotacap powder with normal saline as solvent. Apart from subjective assesment , the improvement was measured with Mini Wright Peak Flow Meter(PEFR). Averge PEFR was 200 lits per min before and 350 lits per min after rota nebulisation. Twenty five subjects with similar complaints were taken as control.They were assesed with salbutamol inhaler attached to spacer. The revesibility of the airways obstruction is better with this device as the entire 200mcg salbutamol is delivered properly. In contrast the drug delivery with the inhaler attached to the spacer is supposed to be only 40%. Over and above the users preferred this device as there is no inspiratory effort.
Advantages: 1.Portability 2.Independent of Electricity 3.Ubiquitous Use.4.Long lasting 5.use of rotacap powder instead of costly inhaler