266 Maintenance, bacterial contamination and performance of jet nebulizers used by out patients

Jet nebulizers are frequently used for asthma treatment in children. Aim of study To evaluate technical maintenance, cleaning procedures, bacterial contamination and performance of nebulizers used by out patients. Methods We selected 39 families where an asthmatic child was on maintenance treatment with a nebulizer. User aspects of nebulizer therapy were evaluated with a questionnaire. Bacterial samples were taken from the liquid container of the nebulizer, the NaCl 0.9% solutions used as diluent, and from the aerosol. We measured the operating pressure generated by the compressor with a manometer. Particle-size of the aerosol was measured by laser diffraction. Results None of the nebulizers were periodically maintained. The cleaning procedure was insufficient in 38% of the users. One or more strains of pathogenic micro-organisms were cultured from 18/39 reservoirs, 16/39 NaCl 0.9% solutions, and 5/10 aerosols. Operating pressure was lower than specified by the manufacturer in 50% of the nebulizers. There was a straight negative linear correlation between age of the nebuliser and the respirable output. Conclusion Periodically technical maintenance of nebulizers and evaluation of user aspects is needed. Only single dose vials of NaCl 0.9% should be used to dilute aerosol medication.