Comparison of the Application of Vibrating Mesh Nebulizer and Jet Nebulizer in Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta‐analysis

Abstract

Objective

To comparison of the application of Vibrating Mesh Nebulizer and Jet Nebulizer in chronic obstructive pulmonary disease (COPD).

Research Methods

This systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) statements. The primary outcome measures analyzed included: The amount of inhaler in the urine sample at 30 minutes after inhalation therapy (USAL0.5), The total amount of inhaler in urine sample within 24 hours (USAL24), Aerosol emitted, Forced expiratory volume in 1 second (FEV₁), Forced vital capacity (FVC).

Results

Ten studies were included with a total of 314 study participants, including 157 subjects in the VMN group and 157 subjects in the JN group. The data analysis results of USAL0.5, MD (1.88 [95% CI, 0.95 to 2.81], P = 0.000), showed a statistically significant difference. USAL24, MD (1.61 [95% CI, 1.14 to 2.09], P = 0.000), showed a statistically significant difference. The results of aerosol emitted showed a statistically significant difference in MD (3.44 [95% CI, 2.84 to 4.04], P = 0.000). The results of FEV₁ showed MD (0.05 [95% CI, −0.24 to 0.35], P=0.716), the results were not statistically significant. The results of FVC showed MD (0.11 [95% CI, −0.18 to 0.41], P=0.459), the results were not statistically significant. It suggests that VMN is better than JN and provides higher aerosols, but there is no difference in improving lung function between them.

Conclusion

VMN is significantly better than JN in terms of drug delivery and utilization in the treatment of patients with COPD. However, in the future use of nebulizers, it is important to select a matching nebulizer based on a combination of factors such as mechanism of action of the nebulizer, disease type and comorbidities, ventilation strategies and modes, drug formulations, as well as cost-effectiveness, in order to achieve the ideal treatment of COPD.

Keywords:

• chronic obstructive pulmonary disease
• aerosol
• vibrating mesh nebulizers
• jet nebulizers
• meta-analysis

Acknowledgments

The authors gratefully acknowledge all the authors who shared the results of the included studies, the support of the Clinical Medical Research Center of Lanzhou University First Hospital, (Lanzhou, China), and the First Clinical Medical College of Lanzhou University.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This work was supported by the Project for the First Hospital Fund of Lanzhou University (grant no. ldyyyn2019-66). Funder had no role in the design of the study, the collection and analysis of the data, or the preparation of the manuscript.