Westmed Knows Aerosols. For over 20 years, Westmed has been in the aerosol drug delivery business, providing high quality jet nebulizers and a comprehensive family of aerosol delivery systems to meet every conceivable need. Before that, principles currently at Westmed brought the highly successful Acorn nebulizer to market while at Marquest. When the Westmed company was formed, the Acorn nebulizer was brought to Westmed where it was slightly modified and legs were added so that it would support itself without tipping. It was renamed VixOne and remains unchanged and extensively utilized today. The VixOne is commonly used by itself in the standard ‘tee’ configuration as well as in combination with the Circulaire II and Circulaire II Hybrid high-efficiency aerosol drug delivery systems.

In 2008 Westmed introduced the improved Circulaire, dubbed the Circulaire II, which featured a top-hinged ‘flapper valve,” instead of the old center-post one-way valve used in the original Circulaire, plus a thin-film reservoir bag instead of the thick vinyl reservoir bag used in the original Circulaire. These improvements vastly increased the mass of drug in each inhalation and the total mass of drug capable of being delivered. These enhancements enabled the Circulaire II to more than double it’s previous drug delivery rate and to deliver more than double the drug delivery of competing devices while shortening treatment time to half as much.

In 2010 Westmed introduced the Circulaire II Hybrid version that substitutes an elastomeric reservoir ball in place of the thin-film bag. The ergonomically designed reservoir ball may be easily attached and detached for cleaning in the home treatment environment. Plus, it stands up without tipping for rinsing and drying after cleaning and can also be used in the hospital for “sticky” drugs that would previously interfere with proper motion of the bag.

VixOne Small Volume Medication Nebulizer.
The VixOne is Westmed’s primary aerosol generator. It is used as a ‘stand alone’ nebulizer configured to a tee piece, 6-inch reservoir tube and mouthpiece and is also used on the specialized Pedi-Neb pacifier/nebulizer for infants and toddlers.  However, most importantly, the VixOne has been the reliable aerosol generator on both versions of the Circulaire aerosol delivery system over the years.  This section references studies that used the VixOne Small Volume Medication Nebulizer.

Gardenhire DS, Ari A, Zimmerman C, Parkman S.  An in vitro comparison of dosimetric and constant output nebulizers. Respir Care 2007; 52(11):1580.

Geller DE, Kesser B.  Blowby vs face mask for nebulized drugs in young children.  J Allergy Clin Immun 2004; 113:2 (Suppl), S32.

Zhou Y, Ahuja A, Irvin CM, et al.  Evaluation of nebulizer performance under various humidity conditions.  J Aerosol Med 2005; 18(3):283-293.

Zhou Y, Ahuja A, Irvin CM, et al.  Medical nebulizer performance: Effects of cascade impactor temperature.  Respir Care 2005; 50(8):1077-1082.

Marra F, Partovi N, Wasan KM, et al.  Amphotericin B disposition after aerosol inhalation in lung transplant recipients.  Ann Pharmacotherapy 2002; 36(1):46-51.

O’Riordan TG, Weinstein MD, Mao Y.  Bench testing of nebulizers: A comparison of three methods.  J Aerosol Med 1999; 12(2):59-66.

Hess D, Fisher D, Williams P, et al.  Medication nebulizer performance: Effects of diluent volume, nebulizer flow, and nebulizer brand.  Chest 1996; 110:498-505.


Original Circulaire High-Efficiency Aerosol Drug Delivery System (Pre-2008).
The section references papers and studies that utilized the original Circulaire aerosol drug delivery system that was introduced to the market in the early 1990s.

Rau JL.  The inhalation of drugs: Advantages and problems.  Respir Care 2005; 50(3);367-382.

Rau JL, Ari A, Restrepo RD.  Performance comparison of nebulizer designs: Constant-output, breath-enhanced, and dosimetric.  Respir Care 2004; 49(2);174-179.

Monroe KW, Nichols MH, King WD, et al.  Comparison of two forms of albuterol for treatment of acute bronchospasm in pediatric patients.  Southern Med J 2003; 96(5):440-444.

Dennis J, Nerbrink O.  New nebulizer technology in Bisgaard H, O’Callghan C, Smaldone GC (eds).  Drug Delivery to the Lung. 2002, Marcel Dekker, Inc. New York NY.

Hess DR.  Nebulizers: Principles and performance.  Respir Care 2000; 45(6):609-622.

Mason JW, Miller WC. Abbreviated aerosol therapy for improved efficiency.  J Aerosol Med 1998; 11(3):127-131.

Hoffman L, Smithline H.  Comparison of Circulaire to conventional small volume nebulizer for treatment of bronchospasm in the emergency department.  Respir Care 1997; 42(12):1170-1174.

O’Riordan TC, Amram JC.  Effect of nebulizer configuration on delivery of aerosolized tobramycin.  J Aerosol Med 1997; 10(1):13-23.

Mason JW, Miller WC.  Comparison of aerosol delivery via Circulaire nebulizer system versus a disposable nebulizer in COPD patients.  Respir Care 1996; 41(11):1006-1008.

Perry W.  Case study: Circulaire: Time-saving aerosols.  Advance for Respiratory Therapy 1995; 12:78-79.

Miller WC, Mason JW.  Evaluation of the Circulaire aerosol drug delivery system for bacterial contamination.  White Paper, March 14, 1994.

Mason JW, Miller WC.  Comparison of aerosol delivery via Circulaire system vs conventional small volume nebulizer.  Respir Care 1994; 39(12);1157-161.


Circulaire II, Circulaire II Hybrid (2008 and later).
This section references papers and studies involving the improved Circulaire II high-efficiency aerosol drug delivery system that appeared on the market in early 2008. 

McPeck M.  In vitro inhaled aerosol comparison of a conserver nebulizer (Circulaire II) vs a breath-actuated nebulizer.  Respir Care 2010; 55(11): 1564.

McPeck M.  Financial impact spreadsheet for comparing total cost of aerosol drug delivery systems.  Respir Care 2010; 55(11): 1558.

Gardenhire D.  An in vitro comparison of dosimetric nebulizers.  Am J Respir Crit Care Med 2011; 183:A4430.

Okere NC.  Cost-benefit analysis of a dosimetric nebulizer using Circulaire and a traditional VixOne nebulizer. Thesis 2011. Georgia State University, Atlanta Georgia. [ digitalarchive.gsu.edu/rt_theses/8/ ]

Gardenhire DS.  Improved aerosol delivery with a conserver-type nebulizer system powered by 6 common home air compressors.  Accepted for presentation at the American Association for Respiratory Care for the AARC Open Forum to be held November 2013.  Abstract to be published in Respiratory Care Journal, October 2013.

Grzeskowiak M, McKee B.  Evaluation of the Circulaire II aerosol drug delivery system for microbiological contamination. Respir Care 2013; 58(10): 1722.

McPeck M, Gardenhire DS.  Influence of sonic energy on concomitant aerosol delivery with the Vibralung Acoustical Percussor.  Presented at the North American Cystic Fibrosis Conference to be held October 2013.  Peds Pulmon 2013; 48(S36): 364-365.

Dennis JH.  (Video) Westmed Circulaire II selected for exciting new asthma rescue drug.  SolAeroMed S-1226.  http://www.youtube.com/watch?v=J6S6z71dZNk  and  http://www.solaeromed.com/s-1226 (see embedded video)

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