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Looking for a Great Nebulizer Compressor


Posted by Stacy M. Facebook

I currently use the Pair Proneb II compressor and it is taking 40 minutes to do one xopenex/pulmicort treatment.  I think I need a new machine and would like to research first to see what machine people like best.
 
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I, too, am experiencing ongoing issues with this machine.  Actually sent it back under warranty 2 months into ownership. (9 mls of tobramycin were taking 1.5 hrs).  Lots of difficulties getting straight answers.   Children's Hospital recommended the compressor and  insisted we use the Pari Star nebulizer because the orifice size is the smallest.  The theory is that this makes the droplets smaller so that they can get deep into the airways.  Adult clinic didn't have any info/ answers for me even though I asked everyone.   Spoke to the med supply rep who eventually came back with an answer that the Tobra meds were too sticky and were plugging the nebulizer orifice on the Star.  By that time we were finished the meds and hoping for a long stretch before the next reinfection.

The next positive culture we ended up Googling and reading a whole bunch of research papers, dating back to the 90's, which compared compressors and nebulizers.  They used a Pari compressor but only coupled it with the LC Plus nebulizer in their studies in spite of it having the largest orifice size.  Since the research was so old I spoke to the sales rep who recommended the Pari LC Sprint - orifice size between the Star and the LC. Plus.  We ordered one of each (Sprint and Plus) Started using the Plus and treatments with the new 5 ml TOBI nebules were down to 20 mins.  We were in heaven.  Then we managed to boil dry the nebulizer so had to switch to the Sprint.  Initally treatments were taking about 25-30 minutes - still not bad.  But, over the past month, this has grown longer and longer  (now takes over an hour).  

My assessment is that the tobi leaves a residue in places that I can't scrub.  My conclusion for this is that I noticed a Tobi residue on our "disinfecting pot" after it had been washed.  There was a white powdery residue on the sides which I couldn't wipe off, I had to use a pot scubber.  So now I use a bottle brush on the nebulizer before I boil it, but there is one place it can't reach.  It is inside the cap that fits over the orifice opening to force the air down into the medication solution. And that is the place we are having the most difficulty with.  What is happening is that the Tobi somehow blocks the flow of air out of the orifice and down into the residue.  Frequently during treatments we need to disassemble the unit and physically lift the orifice cap to resume air flow.

So the question is one of whether the new Sprint design is suited for TOBI administration, whether the same problems would be experienced with another medication, or whether the pressure of a more powerful compressor would be able to overcome those blockages?

I'm not really giving you any answers for your compressor.  What I am saying is that maybe your compressor isn't the problem, maybe it's the medication.  We have never used your meds so I can't comment on them.  As a secondary thought, what kind of shape is your filter in?  Perhaps it needs changing.

I would like to add that when we were doing the research we looked at the newer ultrasonic units.  We thought that such a unit, with it's supposed faster through-put and battery capability would lend itself well to our needs.  We have learned that they are not always suitable as some medications are negatively affected by the heat they produce.

Sadly, I found it difficult to get info about system specs and more importantly, what is optimal for CF patients and their meds.  Because, of course, our meds are very different from those used by the typical asthmatic patient.

Best of luck in your search.

Valerie - CF Mom

I use the PARI E Flow which has transformed my nebulising time completely, for example i used to nebulise 5 mls tobi on my old compressor - it took 20 minutes, now it takes 3-4 minutes.  Much faster and less irritation caused to my throat.  Unit is very small, comes with rechargeable batteries and a set of international plugs - great for travelling if your able to.  Only downside is that mesh needs replaced every 12 months or thereabouts - you will know when this is needed as nebulising drugs takes a little longer.  CF patient from ireland.
There is an option no one seems to entertain and that is getting an oxygen tank with a regulator, and hooking it up to your nebulizer. This gets very satisfactory results, and it absolutely does wonders for getting oxygen to your brain. If I ever start nebulizing that is the way I am going to go... It is a win - win situation. But finding a Dr. to approve it so your insurance will cover the cost may be another problem... But it is worth a shot... Personally I don't see what the difference is if you have an Ox2 going to your nose or running a nebulizer with it, as far as cost.
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