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The I-neb AAD Nebuliser

The I-neb is a small, battery powered, lightweight and virtually silent drug delivery device. It significantly reduces the inconvenience of conventional nebulizer/compressor therapy while delivering a precise, reproducible dose.1

Included as part of the Promixin package. Including replacement if faulty, lost or broken.

1) Promixin 1 million International Units (IU) Powder for Nebuliser Solution, Summary of Product Characteristics, 12th October 2021

  • Adaptive aerosol delivery system optimizes drug delivery

  • Long battery life leaves patients free to plan their day

  • Specific metering chambers for dosage control

  • AAD algorithm for adaptive treatment

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Find out more about the I-neb AAD Nebuliser below

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How does the I-neb tailor aerosol delivery?

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How does aerosol delivery with the I-neb compare with constant flow nebulisers 

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How does orientation affect I-neb and constant flow nebulisers?

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How does the
I-neb chambers deliver different doses 

1

How does the I-neb tailor it's aerosol delivery?

I-neb aerosol delivery
Patient's can't turn the I-neb on and walk away like a continuous flow nebuliser...


Unlike a continuous flow nebuliser, the I-neb AAD will only deliver medication when patients inhale, meaning you can be sure that patients are taking their required dose and the medication is not being wasted.



 
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Adaptive Aerosol Delivery (AAD) algorithm for adaptive treatment

The I-neb pulses medication delivery into 50 to 80% of each inspiration, based on a rolling average of the last three breaths. Throughout the treatment, the I-neb provides continuous feedback to the patient. Upon successful delivery, the patient receives audible and tactile feedback.

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Adaptive Aerosol Delivery (AAD) system optimizes drug delivery

This technology ensures optimal drug delivery by only delivering medication when the patient inhales. This gives the medication the best opportunity to reach deep into the lungs and greatly reduces waste to the environment. AAD delivers the right amount of medication, regardless of size or breathing patterns.

What is Tidal Inhalation Mode (TIM) and how does it work?

This video explains how the I-neb TIM mode works to deliver superior lung deposition compared with unguided breathing technique

The I-neb will work in TIM mode when the specific mouthpiece is attached. 

You can tell it is a TIM mouthpiece by checking this rectangle is in the corner of the mouthpiece

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How does aerosol delivery with an I-neb AAD device compare to a constant flow nebuliser?

The delivery of colistimethate sodium (CMS) by three different nebulisers, using a breath simulator, was investigated in four different inhalation : exhalation (I:E) ratios.

I-neb deliver constant flow nebuliers vs

What are Inhalation : Exhalation (I:E) ratios?

Inhalation : Exhalation (I:E) ratios provide the average ratio of time taken on inspiration and expiration.

 

Resting Inhalation : Exhalation (I:E) ratio times during tidal breathing can vary depending on disease and disease severity.

 

Patients with cystic fibrosis can exhibit a range of I.E. ratios which vary from approximately 1:1.2 to 1:53.

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How does this affect patients using nebulisers?

Continuous flow nebulisers

As displayed in the below diagram, as patients disease progresses and they gradually spend more and more time exhaling than inhaling.

 

As continuous flow nebulisers are always producing aerosol, this means increasingly more aerosol is pumped into the environment and less into the lungs where it is needed as the disease progresses

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I-neb AAD (TIM mode)

As the I-neb AAD only produces aerosol when patients are inhaling, more of the aerosol ends up in the lungs.

 

The I-neb's AAD algorithm also adapts to patients breathing, encouraging them to take longer, deeper breaths which gives the best opportunity for the aerosol to reach deep into the lungs and greatly reduces waste to the environment

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Study Results

How did the I-neb AAD perform against the E-flow rapid across different I:E ratios?

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Adapted from Data on File:EN003: Use of Computational Fluid Dynamics (CFD) to Model Aerosol Deposition in the Lungs of Patients with Cystic Fibrosis (CF)

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Constant output mesh nebuliser (eFlow rapid)
 

  • The average results show that the majority of the delivered dose is exhaled.
     

  • Increasing the time spent during exhalation, as might occur with patients with more severe disease, reduces the amount of drug deposited in the lungs, and increases the amount exhaled.

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Pulsed delivery (I-neb AAD nebuliser)
 

  • The amount of aerosol wasted to atmosphere was very low.
     

  • The predicted dose delivered to the central and peripheral areas of the lungs was higher than for the constant output nebulizer, despite the fact that for the higher dose only 1 vial of colistimethate sodium was needed to fill the nebulizer.
     

  • Longer I:E ratios had limited affect on dose delivered to the lungs

Data on File:EN003: Use of Computational Fluid Dynamics (CFD) to Model Aerosol Deposition in the Lungs of Patients with Cystic Fibrosis (CF)

Conclusions

You can see a summary of the study conclusions below

Study results
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How does device orientation affect dose delivery?

The I-neb contains an out of angle sensor helps the patient with nebulizer orientation.

Device orientation

The delivered volume was measured for different nebulisers (I-neb AAD and eFlow rapid) at orientations of -45˚, 0˚ and +45˚

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Adapted from Data on File:EN003: Use of Computational Fluid Dynamics (CFD) to Model Aerosol Deposition in the Lungs of Patients with Cystic Fibrosis (CF)

The results show that the eFlow rapid was significantly affected by device orientation compared with the I-neb, which remained consistent at all tested device angles

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How does the I-neb deliver different doses?

The I-neb has different chamber types for different medications

I-ne does

The I-neb support three chamber types

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Grey
for Promixin, Salbutamol

Green
for DNase

Lilac
for Promixin, tobramycin, hypertonic saline

(Please note, 2 applications are needed for tobramycin and hypertonic saline doses with this chamber)

Support Materials for Patients

There are a variety of resources for patients online to help them understand and operate their I-neb

Support materials

I-neb patient support can be found at  www.promixinsupport.com 

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The I-neb cleaning guide is now available for patients 

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April 2023

Adverse event reporting
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