Methods and systems for operating an aerosol generator

• US 20030140921A1
• Filed: 01/15/2003
• Published: 07/31/2003
• Est. Priority Date: 05/05/2000
• Status: Active Grant

• Current Assignee: Novartis Pharma AG (Novartis Ag)
• Original Assignee: Aerogen, Inc. (Nektar Therapeutics)
• Inventors: Power, John, Smith, Niall, Fink, James B., Klimowicz, Michael
• Granted Patent: US 6,968,840 B2
• Time in Patent Office: Days
• US Class Current: 128/200.14
• CPC Class Codes: A61J 1/065 Rigid ampoules, e.g. glass ampoules
• CPC Class Codes: A61J 2205/10 Bar codes
• CPC Class Codes: A61J 2205/60 using magnetic or electronic identifications, e.g. chips, RFID, electronic tags
• CPC Class Codes: A61M 15/00 Inhalators drug delivery in endotracheal tubes A61M16/04
• CPC Class Codes: A61M 15/0028 using prepacked dosages, one for each application, e.g. capsules to be perforated or broken-up
• CPC Class Codes: A61M 15/0031 by bursting or breaking the package, i.e. without cutting or piercing
• CPC Class Codes: A61M 15/0033 Details of the piercing or cutting means
• CPC Class Codes: A61M 15/0085 using ultrasonics spraying or atomising liquids using ultrasonic vibrations in general B05B17/06
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/06 Respiratory or anaesthetic masks
• CPC Class Codes: A61M 16/08 Bellows; Connecting tubes having means for taking samples G01N1/22; Water traps; Patient circuits
• CPC Class Codes: A61M 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/0024 with an on-off output signal, e.g. from a switch
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: A61M 2205/6045 having complementary physical shapes for indexing or registration purposes
• CPC Class Codes: A61M 2205/6054 Magnetic identification systems
• CPC Class Codes: A61M 2205/6072 Bar codes
• CPC Class Codes: A61M 2205/8206 battery-operated
• CPC Class Codes: A61M 2205/8262 connectable to external power source, e.g. connecting to automobile battery through the cigarette lighter
• CPC Class Codes: A61M 2209/082 : Mounting brackets, arm supports for equipment
• CPC Class Codes: B05B 17/0646 : Vibrating plates, i.e. plates being directly subjected to the vibrations, e.g. having a piezoelectric transducer attached thereto
• CPC Class Codes: B65D 1/095 : made of flexible material
• CPC Class Codes: B65D 2203/00 : Decoration means, markings, information elements, contents indicators

Abstract

A nebule comprising at least one identification marker or label can be coupled an aerosol generator. The identification marker can be sensed by a sensing device on the aerosol generator so as to identify the liquid in the nebule to the controller of the aerosol generator. The controller of the aerosol generator can control the aerosol generator based on the information read from the identification marker.

Claims

1. A method of creating an aerosol, the method comprising:

providing an aerosol generator;

coupling a nebule to an interface of the aerosol generator;

reading an identification marker on the nebule; and

operating the aerosol generator according to an operation program based on the information read from the identification marker on the nebule.

2. A method as in claim 1 wherein operating comprises selecting the operating program from a plurality of stored operation programs.

3. A method as in claim 1 comprising informing a user of the type of liquid based on the information read from the identification marker.

4. A method as in claim 3 wherein information comprises displaying the type of liquid on an output display.

5. A method as in claim 1 wherein the identification marker comprises a bar code, wherein reading comprises reading the bar code with a bar code reader.

6. A method as in claim 1 wherein the identification marker comprises a protrusion, wherein reading comprises sensing the protrusions with an optical sensor.

7. A method as in claim 1 wherein the identification marker comprises a protrusion, wherein reading comprises contacting a sensor against the protrusion.

8. A method as in claim 1 wherein coupling comprises opening a sealing membrane with the nebule.

9. A method as in claim 1 wherein coupling comprises engaging at least one helical thread of the nebule with a threaded feature of the interface.

10. A method as in claim 9 wherein the identification markers are disposed in a helical configuration that follows a pitch of the helical thread(s).

11. A method of nebulizing a liquid, the method comprising:

taking one or more breaths;

measuring at least one breath characteristic;

taking a subsequent breath; and

operating an aerosol generator based on one or more of the measured breath characteristics.

12. A method as in claim 11 further comprising identifying a liquid in the aerosol generator and further modifying the operation of the aerosol generator based on the identification of the liquid in the aerosol generator.

13. A method as in claim 11 wherein the breath is a tidal breath.

14. A method as in claim 13 wherein identifying is carried out upon insertion of the nebule into a housing of the aerosol generator.

15. A method as in claim 11 wherein measuring comprises monitoring at least one of a group consisting of:

breathing pattern, one or more discrete time points in a breath cycle, peak inspiratory flow rate, breathing rate, exhalation parameters, regularity of breathing, and tidal volume.

16. A method as in claim 11 wherein operating comprises controlling the start and stop times of the aerosol generator.

17. A method as in claim 11 wherein operating comprises establishing an operating program based on the measured breathing characteristics.

18. A method as in claim 17, wherein the operating program controls start and stop times of the aerosol generator.

19. A method of creating an aerosol, the method comprising:

providing an aerosolization element comprising a first face, a second face, and a plurality of apertures therethrough;

providing a vibratory element in mechanical communication with the aerosolization element such that vibration of the vibratory element may cause the aerosolization element to vibrate;

providing an interface to receive a nebule in such a manner that fluid from the nebule may be deposited on the first face of the aerosolization element;

coupling a nebule to an interface of the aerosol generator;

reading an identification marker on the nebule; and

vibrating the aerosolization element generator according to an operation program based on the information read from the identification marker on the nebule.

20. A method as in claim 19 wherein operating comprises selecting the operating program from a plurality of stored operation programs.

21. A method as in claim 19 comprising informing a user of the type of liquid based on the information read from the identification marker.

22. A method as in claim 19 wherein information comprises displaying the type of liquid on an output display.

23. A method as in claim 19 wherein the identification marker comprises a bar code, wherein reading comprises reading the bar code with a bar code reader.

24. A method as in claim 19 wherein the identification marker comprises a protrusion, wherein reading comprises sensing the protrusions with an optical sensor.

25. A method as in claim 19 wherein the identification marker comprises a protrusion, wherein reading comprises contacting a sensor against the protrusion.

26. A method as in claim 19 wherein coupling comprises opening a sealing membrane with the nebule.

27. A method as in claim 19 wherein coupling comprises engaging at least one helical thread of the nebule with a threaded feature of the interface.

28. A method as in claim 27 wherein the identification markers are disposed in a helical configuration that follows a pitch of the helical thread(s).

29. A method of nebulizing a liquid, the method comprising:

providing a vibratory aerosolization element comprising a first face, a second face, and a plurality of apertures therethrough;

taking one or more breaths;

measuring at least one breath characteristic;

taking a subsequent breath;

providing liquid to the first face of the aerosolization element; and

vibrating the aerosolization element based on one or more of the measured breath characteristics.

30. A method as in claim 29 further comprising:

identifying a liquid provided to the aerosolization element; and

basing the operation of the aerosol generator based on the identification of the liquid in the aerosol generator.

31. A method as in claim 29 wherein the breath is a tidal breath.

32. A method as in claim 31 wherein identifying is carried out upon insertion of the nebule into a housing within which the aerosolization element is situated.

33. A method as in claim 29 wherein measuring comprises monitoring at least one of a group consisting of:

breathing pattern, one or more discrete time points in a breath cycle, peak inspiratory flow rate, breathing rate, exhalation parameters, regularity of breathing, and tidal volume.

34. A method as in claim 29 wherein operating comprises controlling the start and stop times of vibration of the aerosolization element.

35. A method as in claim 29 wherein operating comprises establishing an operating program based on the measured breathing characteristics.

36. A method as in claim 35, wherein the operating program controls start and stop times of vibration of the aerosolization element.

37. A method for nebulizing a liquid, comprising:

providing a nebulizer system comprising a housing, an aerosol generator, a controller coupled to the aerosol generator, and a reservoir in communication with the aerosol generator;

providing a nebule comprising a nebule body configured to hold a liquid, wherein the nebule body comprises a key element;

inserting the nebule into the housing, wherein the key element provides access to the reservoir when properly keyed with the housing;

transferring the liquid from the nebule into the reservoir; and

operating the aerosol generator with the controller to aerosolize the liquid.

38. A method as in claim 37, wherein the nebulizer further comprises a slit seal membrane disposed over the reservoir, wherein insertion of the nebule into the housing provides communication from the nebule, through the slit seal membrane, to the reservoir.

39. A method as in claim 37, wherein the housing includes a tab, wherein the key element comprises a slot, and wherein insertion of the nebule causes the tab to fit within the slot when properly keyed.

40. A method as in claim 37, wherein the aerosol generator comprises a plate having a plurality of apertures, and wherein the aerosol generator operating step comprises vibrating the plate

41. A method as in claim 40, wherein the aerosol generator plate comprises a curvature.

42. A method as in claim 40, wherein the plate comprises a dome shape.

43. A method as in claim 37 wherein the key element is a helical thread, and the housing comprises a threaded feature, wherein inserting the nebule comprises rotating the nebule.

44. A method as in claim 37 comprising identifying the liquid disposed within the nebule, and modifying the operation of the aerosol generator based on the type of liquid identified.

45. A method for nebulizing a liquid, comprising:

providing a nebulizer system comprising a housing, an aerosol generator, the aerosol generator comprising an aerosolization element having a first face, a second face and a plurality of apertures therethrough, a vibratory element, a controller coupled to the vibratory element, and a reservoir in fluid communication with the first face of the aerosolization element of the aerosol generator;

providing a nebule comprising a nebule body, the nebule body configured to hold a liquid, and a key element;

inserting the nebule into the housing, wherein the key element provides access to the reservoir when properly keyed with the housing;

transferring the liquid from the nebule into the reservoir; and

operating the aerosol generator with the controller controlling vibration of the vibratory element to draw liquid through the apertures of the aerosolization, from the first face to the second face, to aerosolize the liquid.

46. A method as in claim 45, wherein the nebulizer further comprises a slit seal membrane disposed over the reservoir, wherein insertion of the nebule into the housing provides communication from the nebule, through the slit seal membrane, to the reservoir.

47. A method as in claim 45, wherein the housing includes a tab, wherein the key element comprises a slot, and wherein insertion of the nebule causes the tab to fit within the slot when properly keyed.

48. A method as in claim 45 wherein the key element is a helical thread, and the housing comprises a threaded feature, wherein inserting the nebule comprises rotating the nebule.

49. A method as in claim 45 comprising identifying the liquid disposed within the nebule, and modifying the operation of the aerosol generator based on the type of liquid identified.

50. A method as in claim 45 comprising monitoring at least one breathing characteristic of a user and modifying the operation of the aerosol generator based on the user'"'"'s breathing characteristics.

51. A method as in claim 45 comprising monitoring breathing characteristics of a user and modifying the operation of the aerosol generator based on the user'"'"'s breathing characteristics.

52. A method for nebulizing a liquid, the method comprising:

providing a nebulizer comprising a housing having a gas flow passageway, and aerosol generator, a controller, and a reader;

placing a nebule having a liquid into the housing;

reading an identification marker on the nebule with the reader to identify the liquid;

transferring liquid from the nebule to the aerosol generator; and

operating the aerosol generator with the controller using an operation program selected by the controller based on the identified liquid to provide an aerosolized liquid in the gas flow passage.

53. A method as in claim 52, wherein the operation program controls start and stop times for the aerosol generator

54. A method as in claim 52, wherein the operation program controls aerosol production rates of the aerosol generator.

55. A method as in claim 52, wherein the operation program selected by the controller is selected from a plurality of stored operation programs.

56. A method as in claim 55, wherein the plurality of operation programs are indexed to one or more liquids.

57. A method as in claim 56, wherein the selection of an operation program is based on identifying the liquid in the ampoule as on one of the indexed liquids, and further comprising selecting an operation program indexed to that identified liquid.

58. A method as in claim 52, further comprising:

inhaling through the passageway to produce a gas flow through the passageway;

sensing the gas flow with a sensor; and

modifying the operation of the aerosol generator based on the characteristics of the gas flow information measured by the sensor.

59. A method of nebulizing a liquid, the method comprising:

providing an aerosol generator;

delivering a fluid from a nebule to the aerosol generator;

reading an identification marker on the nebule;

measuring one or more breathing characteristics of the patient'"'"'s breath; and

operating the aerosol generator based on the information read from the identification marker on the nebule and the one or more measured breathing characteristics of the patient.

60. A method as in claim 59 wherein coupling comprises keying the nebule with the interface, wherein the nebule can deliver fluid to the aerosol generator only if the nebule is properly keyed to the interface.

61. A method as in claim 59 wherein delivering fluid comprises passing a bottom end of the nebule through a slit seal membrane.

62. A method identifying a liquid that is to be delivered to an aerosolization device, the method comprising:

inserting an ampoule into an ampoule interface of an aerosol generator;

rotating a threaded element on the ampoule into engagement with a corresponding threaded feature in the interface so as to pass an identification marker by a sensor; and

sensing the identification marker on the ampoule to identify the liquid in the ampoule.

63. A method as in claim 62 comprising pushing a tip of the ampoule through a slit seal during rotating.

64. A method as in claim 62 wherein sensing comprises reflecting a light off of the markers and detecting the reflected light.

65. A method as in claim 64 wherein the marker comprises at least one protrusion.

66. A method as in claim 64 wherein the at least one protrusion is disposed in a helical pattern that coincides with a pitch of the threaded element.

67. A method as in claim 62 wherein sensing comprises mechanical contact between an identification marker and an adjacent electromechanical sensor.

68. A method as in claim 62 wherein rotating and sensing are carried out simultaneously.

69. An aerosol generator system comprising:

an aerosol generator comprising an interface;

a sensing device coupled to the aerosol generator; and

an ampoule that is attachable to the interface, wherein the ampoule comprises at least one identification marker that can be detected by the sensing device.

70. An aerosol generator system according to claim 69, wherein the interface is configured to receive the ampoule in such a manner that at least one identification marker reaches a proximity of the sensing device sufficient for the sensing device to sense the identification marker.

71. The aerosol generator of claim 69 comprising a controller coupled to the sensing device and to the aerosol generator, wherein the controller operates the aerosol generator based on the identification marker detected by the sensing device.

72. The system of claim 69 wherein the ampoule comprises a helical shaped thread that can threadedly attach to a threaded interior of the interface.

73. The system of claim 72 wherein the markers are disposed in a helical configuration that follows the pitch of the helical shaped thread.

74. The system of claim 69 wherein the sensing device comprises a lightsource and an optical detector.

75. The system of claim 74 wherein the markers comprise a double helical shape.

76. The system of claim 69 wherein the marker comprises a series of protrusions.

77. A nebulizer system comprising:

a housing defining a passageway that is adapted to deliver an aerosolized liquid to a user;

an aerosol generator disposed to provide an aerosolized liquid into the passageway;

a controller having a memory and a plurality of aerosol generator operation programs that control operation of the aerosol generator; and

a reader that is configured to read an identification marker on a nebule having a supply of liquid for the aerosol generator, and to send information from the identification marker to the controller,

wherein the controller is further configured to operate the aerosol generator according to one of the operation programs based on the information from the marker.

78. A nebulizer system as in claim 77, further comprising a flow sensor that is adapted to sense gas flows through the passageway and to send gas flow information to the controller, and wherein the controller is further configured to control operation of the aerosol generator based on the gas flow information.

79. A nebulizer system as in claim 77, wherein the operation programs are configured to control start and stop times for the aerosol generator.

80. A nebulizer as in claim 77, wherein the identification marker includes a bar code.

81. A nebulizer system as in claim 77, wherein the operation programs are configured to control aerosol production rates of the aerosol generator.

82. A nebulizer system as in claim 77, wherein the controller is configured to estimate a user'"'"'s tidal volume based on the gas flow information and to select one of the operation programs based on the tidal volume.

83. A nebulizer as in claim 77, wherein the aerosol generator comprises a plate having a plurality of apertures and a vibratable element to vibrate the plate.

84. A nebulizer system comprising:

a housing defining a passageway that is adapted to deliver an aerosolized liquid to a user;

an aerosol generator disposed to provide an aerosolized liquid into the passageway;

a flow sensor disposed to sense gas flows through the passageway; and

a controller that is configured to determine at least one characteristic of user inhalation based on information from the flow sensor and to control operation of the aerosol generator based on the user inhalation characteristic.

85. A nebulizer system as in claim 84, wherein the inhalation characteristic is selected from a group consisting of breathing patterns, one or more discrete points in a breathing cycle, peak inspiratory flow rate, breathing rate, exhalation parameters, regularity of breathing, and tidal volume.

86. A nebulizer system as in claim 84, wherein the controller is configured to control start and stop times for the aerosol generator based on the inhalation characteristic.

87. A nebulizer system as in claim 84, wherein the controller is configured to control aerosol production rates of the aerosol generator based on the inhalation characteristic.

88. A nebulizer system as in claim 84, further comprising a reader that is configured to read an identification marker on a nebule having a supply of liquid for the aerosol generator, and wherein the controller is further configured to control operation of the aerosol generator based on identification information from the reader.

89. A nebulizer system as in claim 84, wherein the aerosol generator comprises a plate having a plurality of apertures and a vibratable element to vibrate the plate.

90. A nebule comprising:

a nebule body holding a liquid that is adapted to be supplied to an aerosol generator of a nebulizer; and

an identification marker on the nebule body, the identification marker having information identifying the liquid, wherein the identification marker is readable by the nebulizer to control operation of the aerosol generator based on the information.

91. A method of creating an aerosol, the method comprising:

providing an aerosolization element comprising a first face, a second face, and a plurality of apertures therethrough;

providing a vibratory element in mechanical communication with the aerosolization element such that vibration of the vibratory element may cause the aerosolization element to vibrate;

providing an interface to receive a nebule in such a manner that fluid from the nebule may be deposited on the first face of the aerosolization element;

coupling a nebule to an interface of the aerosol generator;

reading an identification marker on the nebule; and

vibrating the aerosolization element generator according to an operation program based on the information read from the identification marker on the nebule.

92. A method as in claim 91 wherein operating comprises selecting the operating program from a plurality of stored operation programs.

93. A method as in claim 91 comprising informing a user of the type of liquid based on the information read from the identification marker.

94. A method as in claim 93 wherein information comprises displaying the type of liquid on an output display.

95. A method as in claim 91 wherein the identification marker comprises a bar code, and wherein the reading comprises reading the bar code with a bar code reader.

96. A method as in claim 91 wherein the identification marker comprises a protrusion, wherein reading comprises sensing the protrusions with an optical sensor.

97. A method as in claim 91 wherein the identification marker comprises a protrusion, wherein reading comprises contacting a sensor against the protrusion.

98. A method as in claim 91 wherein coupling comprises opening a sealing membrane with the nebule.

99. A method as in claim 91 wherein coupling comprises engaging at least one helical thread of the nebule with a threaded feature of the interface.

100. A method as in claim 99 wherein the identification markers are disposed in a helical configuration that follows a pitch of the helical thread(s).

101. A method of nebulizing a liquid, the method comprising:

providing an aerosolization element comprising a first face, a second face, and a plurality of apertures therethrough;

taking one or more breaths;

measuring at least one breath characteristic;

taking a subsequent breath;

providing liquid to the first face of the aerosolization element; and

vibrating the aerosolization element based on one or more of the measured breath characteristics.

102. A method as in claim 101 further comprising identifying a liquid in the aerosol generator and further modifying the operation of the aerosol generator based on the identification of the liquid provided to the aerosolization element.

103. A method as in claim 101 wherein the breath is a tidal breath.

104. A method as in claim 103 wherein identifying is carried out upon insertion of the nebule into a housing within which the aerosolization element is situated.

105. A method as in claim 101 wherein measuring comprises monitoring at least one of a group consisting of:

breathing pattern, one or more discrete time points in a breath cycle, peak inspiratory flow rate, breathing rate, exhalation parameters, regularity of breathing, and tidal volume.

106. A method as in claim 101 wherein operating comprises controlling the start and stop times of vibration of the aerosolization element.

107. A method as in claim 101 wherein operating comprises establishing an operating program based on the measured breathing characteristics.

108. A method as in claim 107, wherein the operating program controls start and stop times of vibration of the aerosolization element.

109. A nebulizer system comprising:

a housing defining a passageway that is adapted to deliver an aerosolized liquid to a user, wherein the housing further includes an nebule interface;

an aerosol generator disposed to provide an aerosolized liquid into the passageway;

a reservoir in the housing that is configured to hold liquid for the aerosol generator;

a slit seal membrane disposed over the reservoir; and

a nebule having a supply of liquid and a key that is configured to interface with the nebule interface and configured to protrude through the slit seal membrane when properly interfaced with the housing, whereby the slit seal membrane is opened to permit the liquid to be transferred from the nebule and into the reservoir.

110. A nebulizer as in claim 109, wherein the key comprises a slot in the nebule, and wherein the nebule interface comprises a tab that fits within the slot.

111. A nebulizer as in claim 109, wherein the aerosol generator comprises a plate having a plurality of apertures and a vibratable element to vibrate the plate.

112. A system for providing air with nebulized liquid to a patient receiving air from a ventilator, comprising:

a ventilator;

a ventilator circuit configured to deliver air from the ventilator to a patient;

a nebulizer positioned to emit an aerosol into the ventilator circuit and a stream of air coming from the ventilator, the nebulizer comprising;

a vibratory element;

an aerosolizing element having a first face, a second face and a plurality of apertures therethrough;

an actuator in mechanical communication with the vibratory element and with the aerosolizing element, such that a liquid at one face of the aerosolizing element can be drawn through the apertures and be emitted from the other face as an aerosol upon vibration of the vibratory element; and

an electronic circuitry in electrical communication with the vibratory element such that upon a predetermined amount of electric current traveling within the electronic circuitry the vibratory element will be caused to vibrate;

wherein the circuitry is configured to control vibration of the vibratory element between a resting state, in which substantially no aerosol would be produced by the nebulizer, and an active state, in which the vibratory element will vibrate such that aerosol would be produced by the nebulizer, based on an electrical signal provided to the vibratory element from the electronic circuitry.

113. The apparatus of claim 112 wherein the electronic circuitry can control operation of the nebulizer from substantially no aerosol being produced to aerosol being produced in a period of about 0.02 and about 50 milliseconds.

114. The apparatus of claim 112 wherein the electronic circuitry can control operation of the nebulizer from substantially no aerosol being produced to aerosol being produced in a period of about 0.2 and about 50 milliseconds.

115. The apparatus of claim 112 wherein the electronic circuitry can control operation of the nebulizer from substantially no aerosol being produced to aerosol being produced in a period of about 2 and about 50 milliseconds.

116. The apparatus of claim 112 wherein the electronic circuitry can control operation of the nebulizer from substantially no aerosol being produced to aerosol being produced in a period of about 0.02 and about 20 milliseconds.

117. The apparatus of claim 112 wherein the electronic circuitry can control operation of the nebulizer from substantially no aerosol being produced to aerosol being produced in a period of about 0.2 and about 20 milliseconds.

118. The apparatus of claim 112 wherein the electronic circuitry can control operation of the nebulizer from substantially no aerosol being produced to aerosol being produced in a period of about 0.02 and about 2 milliseconds.

119. The apparatus of claim 112 wherein the electronic circuitry can control operation of the nebulizer from aerosol being produced to substantially no aerosol being produced in a period of about 0.02 and about 50 milliseconds.

120. The apparatus of claim 112 wherein the electronic circuitry can control operation of the nebulizer from aerosol being produced to substantially no aerosol being produced in a period of about 0.2 and about 50 milliseconds.

121. The apparatus of claim 112 wherein the electronic circuitry can control operation of the nebulizer from aerosol being produced to substantially no aerosol being produced in a period of about 2 and about 50 milliseconds.

122. The apparatus of claim 112 wherein the electronic circuitry can control operation of the nebulizer from aerosol being produced to substantially no aerosol being produced in a period of about 0.02 and about 20 milliseconds.

123. The apparatus of claim 112 wherein the electronic circuitry can control operation of the nebulizer from aerosol being produced to substantially no aerosol being produced in a period of about 0.2 and about 20 milliseconds.

124. The apparatus of claim 112 wherein the electronic circuitry can control operation of the nebulizer from aerosol being produced to substantially no aerosol being produced in a period of about 2 and about 20 milliseconds.

125. The apparatus of claim 112 wherein the electronic circuitry can control operation of the nebulizer from aerosol being produced to substantially no aerosol being produced in a period of about 0.02 and about 2 milliseconds.

126. The apparatus of claim 112 wherein the electronic circuitry can control operation of the nebulizer from aerosol being produced to substantially no aerosol being produced in a period of about 0.2 and about 2 milliseconds.

127. The apparatus of claim 112 wherein the ventilator is configured to produce a continuous flow of air.

128. The apparatus of claim 112 wherein the ventilator is configured to generate inspiratory air for a predetermined time and cycle between generating inspiratory air and not generating inspiratory air at a predetermined frequency.

129. The apparatus of claim 112 wherein the ventilator is configured to produce inspiratory air for a predetermined time upon a patient'"'"'s effort to begin an inspiration.

130. The apparatus of claim 112 wherein the ventilator is further configured to produce a constant basal level of inspiratory air when the ventilator is not producing inspiratory air in response to a patient'"'"'s effort to begin an inspiration, and then produce inspiratory air for a predetermined time upon a patient'"'"'s effort to begin an inspiration.

131. The apparatus of claim 112, wherein the nebulizer further comprises a pressure transducer that comprises a first location and a second location and which is configured to send a signal based on a predetermined sensed pressure differential between the first location and the second location.

132. The apparatus of claim 131, wherein the first location and the second location are within the breathing circuit.

133. The apparatus of claim 131, wherein the first location and the second location are in fluid communication with breathing circuit, such that air may flow from the first location to the second location based on air flowing from the ventilator to the patient.

134. The apparatus of claim 112, wherein the circuitry is configured to control vibration of the vibratory element between the resting state and the active state based on an electrical signal provided to the vibratory element from the electronic circuitry based at least in part on the state of production of air by the ventilator.

135. The apparatus of claim 131, wherein the nebulizer further comprises a pressure transducer that comprises a first location and a second location and which is configured to send a signal based on a predetermined sensed pressure differential between the first location and the second location, and wherein the pressure differential is based at least in part on a predetermined velocity of air provided by the ventilator.

136. The apparatus of claim 134, wherein the electronic circuitry is configured to activate vibration of the vibratory element of the nebulizer based on a first predetermined pressure differential and to stop vibration of the vibratory element of the nebulized based on a second predetermined pressure differential.

137. The apparatus of claim, 136 wherein the first predetermined pressure differential is determined based on a first velocity of air produced by the ventilator.

138. The apparatus of claim 137, wherein the second predetermined pressure differential is determined based on a second velocity of air produced by the ventilator.

139. The apparatus of claim 136 wherein the first predetermined pressure differential is determined based on a first velocity of air produced by the ventilator and the second predetermined pressure differential is determined based on a second velocity of air produced by the ventilator.

193. The apparatus of claim 120, wherein at least one operation sequence provides for signaling the vibratory element to begin vibration based on a predetermined velocity of air provided by the respirator and to stop vibration based on a percentage of inhalation having transpired.

198. The system of claim 193 wherein the predetermined time of the second mode is calculated as a time at which a predetermined percentage of the inspiration has taken place.

201. The system of claim 193, wherein the controller is configured to cause the aerosol generator to generate aerosol based on a predetermined parameter.

202. The system of claim 201 wherein the predetermined parameter is selected from the group consisting of a level of inspiration and a time within a breath.

204. The system of claim 193 wherein the predetermined parameter is selected from the group consisting of a level of inspiration and a time within a breath.

253. The system of claim 125, wherein the point for commencement of aerosolization and the point for cessation of aerosolization are not designed to coincide with the commencement of an exhalation phase and the cessation of an exhalation phase of an inhalation cycle provided by the nebulizer. nebulizer is mounted in a T connector in the inhalation tube of the ventilator circuit and wherein the nebulizer is configured to provide a mist propelled at low velocity such that the mist may occupy a portion of the ventilator circuit between the T and the Y connectors without any force of air.

140. A nebulizer comprising:

an aerosolization element;

a piezoelectric element, in mechanical communication with the aerosolization element;

an electronic circuitry in electrical communication with the piezoelectric element;

a microprocessor in electrical communication with the electronic circuitry;

a sensor to sense at least one predetermined point of the breathing cycle of a user of the nebulizer, the sensor in electrical communication with the microprocessor,

wherein the sensor, the microprocessor, the electronic circuitry and the piezoelectric element are electronically configured and the piezoelectric element and the aerosolization element are mechanically configured so that the aerosolization element can reach a predetermined maximum aerosol production within a predetermined time period from the sensing of the occurrence of a predetermined point of the breathing cycle.

141. The apparatus of claim 140 wherein the predetermined time period is between 0.02 and about 50 milliseconds.

142. The apparatus of claim 140 wherein the predetermined time period is between about 0.2 and about 50 milliseconds.

143. The apparatus of claim 140 wherein the predetermined time period is between about 2 and about 50 milliseconds.

144. The apparatus of claim 140 wherein the predetermined time period is between about 0.02 and about 20 milliseconds.

145. The apparatus of claim 140 wherein the predetermined time period is between about 0.2 and about 20 milliseconds.

146. The apparatus of claim 140 wherein the predetermined time period is between about 0.02 and about 2 milliseconds.

147. A system for providing air with nebulized liquid to a patient receiving air from a ventilator, comprising:

a ventilator;

an inflow pathway configured to carry inhalation air from the ventilator to a patient being ventilated by the ventilator;

an aerosolization element configured to dispense aerosol into the inflow pathway;

a piezoelectric element, in mechanical communication with the aerosolization element;

an electronic circuitry in electrical communication with the piezoelectric element;

a microprocessor in electrical communication with the electronic circuitry; and

a sensor configured to sense at least one predetermined point within the breathing cycle of patient using the ventilator, the sensor in electrical communication with the microprocessor,

wherein the sensor, the microprocessor, the electronic circuitry and the piezoelectric element are electronically configured and the piezoelectric element and the aerosolization element are mechanically configured so that the aerosolization element can reach a predetermined maximum aerosol production within a predetermined time period from the sensing of the occurrence of a predetermined point in the breathing cycle.

148. A system for providing air with nebulized liquid to a patient receiving air from a ventilator, comprising;

a ventilator;

an inflow pathway configured to carry inhalation air from the ventilator to a patient being ventilated by the ventilator;

an aerosolization element configured to dispense aerosol into the inflow pathway;

a piezoelectric element, in mechanical communication with the aerosolization element;

an electronic circuitry in electrical communication with the piezoelectric element;

a microprocessor in electrical communication with the electronic circuitry; and

a signal transmitter configured to generate a signal based on at least one first predetermined point within the breathing cycle of patient using the ventilator, the signal transmitter in electrical communication with the microprocessor;

wherein, the signal transmitter, the microprocessor, the electronic circuitry and the piezoelectric element are electronically configured and the piezoelectric element and the aerosolization element are mechanically configured so that the vibration of the piezoelectric element and the aerosolization element is based on the at least one predetermined point within the breathing cycle.

149. The apparatus of claim 148 wherein the aerosolization element can reach a predetermined maximum aerosol production within a predetermined time period from the sensing of the occurrence of a predetermined point in the breathing cycle.

150. The apparatus of claim 149 wherein the predetermined time period is between 0.02 and about 50 milliseconds.

151. The apparatus of claim 149 wherein the predetermined time period is between about 0.2 and about 50 milliseconds.

152. The apparatus of claim 149 wherein the predetermined time period is between about 2 and about 50 milliseconds.

153. The apparatus of claim 149 wherein the predetermined time period is between about 0.02 and about 20 milliseconds.

154. The apparatus of claim 149 wherein the predetermined time period is between about 0.2 and about 20 milliseconds.

155. The apparatus of claim 149 wherein the predetermined time period is between about 0.02 and about 2 milliseconds.

156. The apparatus of claim 148, wherein the signal transmitter is controlled by the ventilator.

157. The apparatus of claim 156, wherein the signal transmitter is contained within the ventilator.

158. The apparatus of claim 148, wherein, wherein the signal transmitter is configured to halt its signal transmission based at least in part on the at least one second predetermined point within the breathing cycle of patient using the ventilator.

159. The apparatus of claim 148, wherein the signal transmitter is controlled by the ventilator.

160. The apparatus of claim 159, wherein the signal transmitter is contained within the ventilator.

161. The apparatus of claim 148, wherein, wherein the signal transmitter is configured to halt its signal transmission based at least in part on the at least one second predetermined point within the breathing cycle of patient using the ventilator.

162. A method for providing nebulized fluid to a person receiving air from a ventilator, comprising:

identifying the drug to be administered;

selecting an algorithm, the algorithm providing a sequence of starting aerosol production and stopping aerosol production so that the drug is delivered at a predetermined interval of choice in a breathing cycle;

receiving a signal from the ventilator to establish a point of reference as to the operation of the ventilator in providing cycles of comprising inhalation phases;

selecting an operating sequence based the selected algorithm and the reference point;

beginning production of aerosol at a point in the ventilator cycle in accordance with the operating sequence;

stopping production of aerosol at a point in the ventilator cycle in accordance with the operating sequence;

wherein the operating sequence sets the time for beginning production of aerosol and stopping production of aerosol based on the particular drug being administered an based on the specific cycle time of the ventilator to achieve a predetermined efficacy of aerosol administration.

163. A method of providing nebulized fluid to a patient receiving at least a portion of air from an artificial air source, the method comprising:

providing a nebulizing element;

providing a controller to operate the nebulizing element,

choosing a sequence of start and stop of aerosol production to maximize the effect of administered drug as provided in combination with the air provided by the artificial air source.

164. A system for providing nebulized fluid to a patient receiving air from an artificial air source, comprising:

an aerosolization element;

a controller configured to control operation of the aerosolization element;

a plurality of operation algorithms providing for the controller to operate the aerosolization element at predetermined intervals to achieve different regime of administration with respect to an inspiratory cycle, said inspiratory cycle comprising an inhalation phase and an exhalation phase;

wherein the controller may be adjusted to follow one of the algorithms to carry out a specific operation sequence of operating the aerosolization element.

165. The system of claim 164, wherein the controller is manually adjustable by a person operating the system.

166. The system of claim 165, wherein the controller may adjust automatically, by following an initial algorithm that leads the controller to chose an operation algorithm.

167. The system of claim 164, wherein the controller has the ability to chose an alternate operating sequence based on receipt of instantaneous information as to the status of one or more of the group consisting of the breathing rhythm of the patient and the ongoing aerosol production sequence.

168. The system of claim 164, wherein the controller has the ability to follow a portion of a first operation sequence and a portion of a second operation sequence to carry out a third operation sequence that comprises a portion of the first operation sequence and a portion of the second operation sequence.

169. The system of claim 164, wherein the controller selects the portions of the operation sequences based on a sensed parameter in the course of operation of the system by which nebulized fluid is provided in conjunction with air from an artificial air source.

170. A method of providing an apparatus for providing nebulized fluid to a patient receiving air flowing from a respirator, comprising:

providing a nebulizing element, the nebulizing element comprising a first face, a second face and a plurality of apertures therebetween;

providing a vibratory element capable of vibrating upon receiving a predetermined electrical signal, the vibratory element positioned such that the nebulizing element can be caused to vibrate by vibration of the vibratory element in such a manner that a fluid at the first face may be drawn through the apertures and emitted therefrom at the second face as a nebulized mist;

providing a circuitry in electrical communication with the vibratory element;

providing a switch in electrical communication with the circuitry, the switch being operable between an off position and an on position such that the switch maintains itself in the off position if a predetermined velocity of air flowing to the patient is not present and in the on position if the predetermined velocity of air flowing to the patient is present;

wherein the time between the switch being moved from the off position to the on position to the time a nebulized mist can be emitted by vibration of the vibratory element is between about 2 milliseconds and about 50 milliseconds.

171. The method of claim 170 wherein the switch comprises a sensor capable of sensing a pressure differential.

172. The method of claim 171 wherein the pressure differential is calibrated to a predetermined velocity of air flowing to the patient.

173. The method of claim 172 wherein the switch maintains itself in the off position if a predetermined pressure differential is not present and in the on position if the predetermined pressure differential is present.

174. The method of claim 170 wherein the switch comprises a moveable member capable of moving from a first position to a second position.

175. The method of claim 174 wherein the first position corresponds to the absence of air flowing to the patient being of a predetermined velocity and the second position corresponds to the presence of air flowing to the patient being of a predetermined velocity.

176. The method of claim 170 further comprising a sensor to detect the presence of the moveable member in the second position.

177. The method of claim 170 wherein the sensor comprises a light sensor that can sense a difference of light received by it when the moveable member is in the second position than when the moveable member is not in the second position.

178. The method of claim 170 wherein the sensor comprises a film upon the moveable member, the film subject to a change in at least one physical characteristic when the moveable member is in the second position.

179. The method of claim 178 wherein the physical characteristic is electric resistance.

180. The method of claim 178 further comprising an electric sensor capable of sensing the electric resistance of the film corresponding to the moveable member being in the second position.

181. A method of providing nebulized fluid into an inspiratory flow of a user, comprising:

providing a ventilator,

providing tubing capable of carrying inspiratory air flowing to the user,

providing a nebulizing element, the nebulizing element comprising a first face, a second face and a plurality of apertures therebetween;

providing a vibratory element capable of vibrating upon receiving a predetermined electrical signal, the vibratory element positioned such that the nebulizing element can be caused to vibrate by vibration of the vibratory element in such a manner that a fluid at the first face may be drawn through the apertures and emitted therefrom at the second face as a nebulized mist;

providing a circuitry in electrical communication with the vibratory element, the circuitry capable of supplying an electrical signal to the vibratory element to cause the vibratory element to vibrate;

providing a switch that can be acted upon by inspiratory air, the switch in electrical communication with the circuitry, the switch being operable between an off position and an on position such that the switch maintains itself in the off position if a predetermined velocity of air flowing to the patient is not present and in the on position if the predetermined velocity of air flowing to the patient is present, the switch being arranged such that if it is in the on position, the circuitry may supply the electrical signal to the vibratory element;

providing a fluid at the first face of the nebulizing element,

providing inspiratory air flowing to the patient, wherein the velocity thereof becomes greater than or equal to the predetermined velocity, thus moving the switch to the on position, whereupon the nebulizing element is caused to vibrate;

wherein the time between the switch being moved to the on position to the time a nebulized mist is emitted by vibration of the vibratory element is between about 2 milliseconds and about 50 milliseconds.

182. A method of providing nebulized fluid into an inspiratory flow of a user, comprising:

providing a ventilator,

providing tubing capable of carrying inspiratory air flowing to the user,

providing a nebulizing element, the nebulizing element comprising a first face, a second face and a plurality of apertures therebetween;

providing a vibratory element capable of vibrating upon receiving a predetermined electrical signal;

positioning the vibratory element such that the nebulizing element can be caused to vibrate by vibration of the vibratory element in such a manner that a fluid at the first face may be drawn through the apertures and emitted therefrom at the second face as a nebulized mist;

providing a circuitry in electrical communication with the vibratory element;

providing a switch in electrical communication with the circuitry and positioned to be acted upon by at least a portion of a stream of inspiratory air, the switch being operable between an off position and an on position such that the switch maintains itself in the off position if a predetermined velocity of air flowing to the patient is not present and in the on position if the predetermined velocity of air flowing to the patient is present;

providing a stream of inspiratory air of which at least a portion thereof comes from the respirator;

allowing the switch to move to the on position upon the stream of inspiratory air attaining a predetermined velocity, whereupon the circuitry causes the vibratory element to vibrate in such a manner as to cause the nebulizing element to vibrate, thereby drawing fluid through the apertures thereof and therethrough emitting a nebulized mist within between about 2 milliseconds and about 50 milliseconds.

183. A method of providing an apparatus for providing nebulized fluid into an inspiratory flow of a user, comprising:

providing a ventilator,

providing tubing capable of carrying inspiratory air flowing to the user,

providing a nebulizing element, the nebulizing element comprising a first face, a second face and a plurality of apertures therebetween;

providing a vibratory element capable of vibrating upon receiving a predetermined electrical signal, the vibratory element positioned such that the nebulizing element can be caused to vibrate by vibration of the vibratory element in such a manner that a fluid at the first face may be drawn through the apertures and emitted therefrom at the second face as a nebulized mist;

providing a circuitry in electrical communication with the vibratory element;

providing a switch in electrical communication with the circuitry, the switch being operable between an off position and an on position such that the switch maintains itself in the off position if a predetermined velocity of air flowing to the patient is not present and in the on position if the predetermined velocity of air flowing to the patient is present;

wherein the time between the switch being moved to the on position to the time a nebulized mist can be emitted by vibration of the vibratory element is between about 2 milliseconds and about 50 milliseconds.

184. A method of providing nebulized fluid to a patient receiving air flowing from a respirator, comprising:

providing a nebulizing element, the nebulizing element comprising a first face, a second face and a plurality of apertures therebetween;

providing a vibratory element capable of vibrating upon receiving a predetermined electrical signal;

positioning the vibratory element such that the nebulizing element can be caused to vibrate by vibration of the vibratory element;

providing a circuitry in electrical communication with the vibratory element;

providing a switch that can be acted upon by inspiratory air and that is in electrical communication with the circuitry, the switch being operable between an off position and an on position such that the switch maintains itself in the off position if a predetermined velocity of air flowing to the patient is not present and in the on position if the predetermined velocity of air flowing to the patient is present;

providing a timer in electrical communication with the circuitry;

providing a stream of inspiratory air of which at least a portion thereof comes from the respirator;

moving the switch to the on position upon the stream of inspiratory air attaining a predetermined velocity,

sending a signal to the vibratory element to vibrate in such a manner as to cause the nebulizing element to vibrate, drawing fluid through the apertures of the nebulizing element;

emitting a nebulized mist;

setting a cycle start time from the sending of the signal to the vibratory element;

moving the switch to the off position upon the velocity of the inspiratory stream falling below the predetermined amount;

ceasing to send the signal to the vibratory element;

noting the time of cessation of the signal;

calculating a first length of time from the setting of the time to the noting the time of cessation;

calculating a second length of time as a fraction of the first length of time;

providing a second stream of inspiratory air of which at least a portion thereof comes from the respirator;

moving the switch to the on position upon the second stream of inspiratory air attaining a predetermined velocity,

sending a second signal to the vibratory element to vibrate in such a manner as to cause the nebulizing element to vibrate, drawing fluid through the apertures of the nebulizing element;

emitting a nebulized mist;

setting a second cycle start time from the sending of the second signal to the vibratory element and counting time therefrom;

upon reaching the second length of time counting from the second cycle start time, ceasing to send the second signal to the vibratory element.

185. A method of providing nebulized fluid to a patient receiving air flowing from a respirator, comprising:

providing a nebulizing element, the nebulizing element comprising a first face, a second face and a plurality of apertures therebetween;

providing a vibratory element capable of vibrating upon receiving a predetermined electrical signal;

positioning the vibratory element such that the nebulizing element can be caused to vibrate by vibration of the vibratory element;

providing a circuitry in electrical communication with the vibratory element;

providing a switch which can be acted upon by inspiratory air and in electrical communication with the circuitry, the switch being operable between an off position and an on position such that the switch maintains itself in the off position if a predetermined velocity of air flowing to the patient is not present and in the on position if the predetermined velocity of air flowing to the patient is present;

providing a timer in electrical communication with the circuitry;

providing a stream of inspiratory air of which at least a portion thereof comes from the respirator;

allowing the switch to move to the on position upon the stream of inspiratory air attaining a predetermined velocity,

allowing a signal to be generated and sent to the vibratory element causing it to vibrate in such a manner as to cause the nebulizing element to vibrate to draw fluid through the apertures of the nebulizing element and emit therefrom the fluid as a nebulized mist;

setting a cycle start time from the sending of the signal to the vibratory element;

moving the switch to the off position upon the velocity of the inspiratory stream falling below the predetermined amount;

ceasing to send the signal to the vibratory element;

noting the time of cessation of the signal;

calculating a first length of time L from the setting of the start time to the noting the time of cessation;

providing a second stream of inspiratory air of which at least a portion thereof comes from the respirator;

allowing the switch to move to the on position upon the second stream of inspiratory air attaining a predetermined velocity,

allowing a second signal to be generated and sent to the vibratory element causing it to vibrate in such a manner as to cause the nebulizing element to vibrate to draw fluid through the apertures of the nebulizing element and emit therefrom the fluid as a nebulized mist;

upon reaching the length of time L counting from the second cycle start time, ceasing to send the second signal to the vibratory element.

186. A method of providing nebulized fluid to a patient receiving air flowing from a respirator, comprising:

providing a respirator;

providing a nebulizing element, the nebulizing element comprising a first face, a second face and a plurality of apertures therebetween;

providing a vibratory element capable of vibrating upon receiving a predetermined electrical signal;

positioning the vibratory element such that the nebulizing element can be caused to vibrate by vibration of the vibratory element;

providing a circuitry in electrical communication with the vibratory element;

providing a switch which can be acted upon by inspiratory air and in electrical communication with the circuitry, the switch being operable between an off position and an on position such that the switch maintains itself in the off position if a predetermined velocity of air flowing to the patient is not present and in the on position if the predetermined velocity of air flowing to the patient is present;

providing a stream of inspiratory air of which at least a portion thereof comes from the respirator;

providing information on the start and stop time of the firing of the respirator;

sending a signal to the vibratory element, upon the firing of the respirator, to vibrate in such a manner as to cause the nebulizing element to vibrate to draw fluid through the apertures of the nebulizing element and emit the fluid therefrom as a nebulized;

ceasing to send the signal to the vibratory element upon the cessation of the firing of the respirator.

187. A method of providing nebulized fluid to a patient receiving air flowing from a respirator, comprising:

providing a respirator;

providing a nebulizing element, the nebulizing element comprising a first face, a second face and a plurality of apertures therebetween;

providing a vibratory element capable of vibrating upon receiving a predetermined electrical signal;

positioning the vibratory element such that the nebulizing element can be caused to vibrate by vibration of the vibratory element;

providing a circuitry in electrical communication with the vibratory element;

providing a switch which can be acted upon by inspiratory air and in electrical communication with the circuitry, the switch being operable between an off position and an on position such that the switch maintains itself in the off position if a predetermined velocity of air flowing to the patient is not present and in the on position if the predetermined velocity of air flowing to the patient is present;

providing a stream of inspiratory air of which at least a portion thereof comes from the respirator;

providing information on the start and stop time of the firing of the respirator;

sending a signal to the vibratory element, upon the elapsing of a predetermined time from firing of the respirator, to vibrate in such a manner as to cause the nebulizing element to vibrate to draw fluid through the apertures of the nebulizing element and emit the fluid therefrom as a nebulized;

ceasing to send the signal to the vibratory element upon the cessation of the firing of the respirator.

188. A method of providing nebulized fluid to a patient receiving air flowing from a respirator, comprising:

providing a respirator;

providing a nebulizing element, the nebulizing element comprising a first face, a second face and a plurality of apertures therebetween;

providing a vibratory element capable of vibrating upon receiving a predetermined electrical signal;

positioning the vibratory element such that the nebulizing element can be caused to vibrate by vibration of the vibratory element;

providing a circuitry in electrical communication with the vibratory element;

providing a sensor that can sense inspiratory air and that is in electrical communication with the circuitry, the sensor providing information as to the presence or absence of a predetermined velocity of air flowing from the respirator;

providing a stream of inspiratory air of which at least a portion thereof comes from the respirator;

providing information on the start time of the firing of the respirator;

vibrating the nebulizing element base upon a combination of information from the sensor and the inform on the start time of the firing of the respirator.

189. A method of providing nebulized fluid to a patient receiving air flowing from a respirator, comprising:

providing a respirator;

providing a nebulizing element, the nebulizing element comprising a first face, a second face and a plurality of apertures therebetween;

providing a vibratory element capable of vibrating upon receiving a predetermined electrical signal;

positioning the vibratory element such that the nebulizing element can be caused to vibrate by vibration of the vibratory element;

providing a circuitry in electrical communication with the vibratory element;

providing a switch which can be acted upon by inspiratory air and in electrical communication with the circuitry, the switch being operable between an off position and an on position such that the switch maintains itself in the off position if a predetermined velocity of air flowing to the patient is not present and in the on position if the predetermined velocity of air flowing to the patient is present;

providing a stream of inspiratory air of which at least a portion thereof comes from the respirator;

providing information on the start and stop time of the firing of the respirator;

sending a signal to the vibratory element, at predetermined time following the firing of the respirator, to vibrate in such a manner as to cause the nebulizing element to vibrate to draw fluid through the apertures of the nebulizing element and emit the fluid therefrom as a nebulized;

ceasing to send the signal to the vibratory element at predetermined period of time prior to the cessation of the firing of the respirator.

190. The method of claim 189 wherein the predetermined period of time following the firing of the respirator and the predetermined time prior to the cessation of the firing of the respirator occur such that the time during which nebulized fluid is emitted is a percentage of an inspiratory cycle.

191. The method of claim 190 wherein the percentage is from about 20 percent to about 50 percent of an inspiratory cycle.

192. An apparatus for providing aerosol to a person receiving air from a respirator, comprising:

an aerosolization element having a first face, a second face, and a plurality of apertures therethrough;

a vibratory element, capable of vibrating upon receiving an predetermined electrical signal, the vibratory element positioned to impart vibration to the aerosolization element;

a circuitry in electrical communication with the vibratory element capable of delivering a predetermined electrical signal to the vibratory element for the vibratory element to vibrate;

a control operable on the circuitry to switch between at least a first mode of operation providing for at least one operation sequence and a second mode of operation providing for at least one operation sequence different from the at least one operation sequence of the first mode.

194. An apparatus for providing aerosol to a person receiving air from a respirator, comprising:

an aerosolization element having a first face, a second face, and a plurality of apertures therethrough;

a vibratory element, capable of vibrating upon receiving an predetermined electrical signal, the vibratory element positioned to impart vibration to the aerosolization element;

a circuitry in electrical communication with the vibratory element capable of delivering a predetermined electrical signal to the vibratory element for the vibratory element to vibrate;

a control operable on the circuitry to switch between three or more modes of operation;

wherein each mode comprises at least one operation sequence different from an operation sequence of one of the other modes.

195. The apparatus of claim 194, wherein one of the modes provides that the circuitry delivers the predetermined signal to the vibratory element during inspiration if the velocity of inspiratory air is above a predetermined velocity, another of the modes provides that the circuitry delivers the predetermined signal to the vibratory element during a portion of the time period in which the velocity of inspiratory air is above a predetermined velocity, and another of the modes provides that the circuitry delivers the predetermined signal to the vibratory element during a portion of time during which the person is exhaling.

196. A system for providing aerosol to a person, comprising:

an aerosol generator;

and a controller configured to cause the aerosol generator to generate aerosol and to cause the aerosol generator to not generate aerosol;

wherein the controller is configured to operate between a first mode and a second mode, wherein the first mode configures the controller to cause the aerosol generate to generate aerosol based on a predetermined inspiration level and to cause the aerosol generator to not generate aerosol based on the absence of a predetermined level of inspiration and the second mode configures the controller to cause the aerosol generator to generate aerosol based on a predetermined level of inspiration and to cause the aerosol generator to not generate aerosol at a predetermined time in the breathing cycle.

197. The system of claim 196 wherein the controller is configured to operate between the first mode, the second mode and a third mode wherein the controller is configured to cause the aerosol generator to generate aerosol at a first predetermined time in the breathing cycle and to stop the aerosol generator from generating aerosol at a second predetermined time in the breathing cycle.

199. The system of claim 197 wherein the first predetermined time of the third mode is set to occur during exhalation and the second predetermined time of the third mode is set to occur during exhalation.

200. The system of claim 197 wherein the second predetermined time is set to occur in the subsequent inspiration.

203. The system of claim wherein the controller is configured to not operate the aerosol generator to not generate aerosol based on a predetermined parameter.

205. A system for providing nebulized fluid to a person comprising:

an aerosol generator; and

a controller, wherein the controller is configured to cause the aerosol generator to begin generation of aerosol at a first predetermined time in a breathing cycle and to stop generating aerosol at a second predetermined time in the breathing cycle.

206. A nebulizer comprising:

an aerosolization element;

a piezoelectric element, in mechanical communication with the aerosolization element;

an electronic circuitry in electrical communication with the piezoelectric element;

a microprocessor in electrical communication with the electronic circuitry;

a sensor to sense at least one predetermined point of the breathing cycle of a user of the nebulizer, the sensor in electrical communication with the microprocessor,

wherein the sensor, the microprocessor, the electronic circuitry and the piezoelectric element are electronically configured and the piezoelectric element and the aerosolization element are mechanically configured so that the aerosolization element can reach a predetermined maximum aerosol production within a predetermined time period from the sensing of the occurrence of a predetermined point of the breathing cycle.

207. A system for providing nebulized fluid into the inflow pathway of a ventilator, comprising;

a ventilator;

an inflow pathway configured to carry inhalation air from the ventilator to a patient being ventilated by the ventilator;

an aerosolization element configured to dispense aerosol into the inflow pathway;

a piezoelectric element, in mechanical communication with the aerosolization element;

an electronic circuitry in electrical communication with the piezoelectric element;

a microprocessor in electrical communication with the electronic circuitry;

a sensor configured to sense at least one predetermined point within the breathing cycle of patient using the ventilator, the sensor in electrical communication with the microprocessor,

wherein the sensor, the microprocessor, the electronic circuitry and the piezoelectric element are electronically configured and the piezoelectric element and the aerosolization element are mechanically configured so that the aerosolization element can reach a predetermined maximum aerosol production within a predetermined time period from the sensing of the occurrence of a predetermined point in the breathing cycle.

208. A fluid droplet ejection device for use with a ventilator, said device produces droplets by a vibratory apertured element during a selected interval of a breathing cycle.

209. A nebulizer for providing nebulized fluid into a ventilator breathing circuit, comprising:

a vibratory aerosolization element having a first face, a second face and a plurality of apertures therethrough;

a controller configured to control vibration of the vibratory aerosolization element,

wherein the controller may be configured to vibrate the vibratory aerosolization element during a selected interval of a breathing cycle.

210. The apparatus of claim 209, wherein the apertures are of substantially uniform exit diameter.

211. The apparatus of claim 209, wherein the apertures are tapered such that liquid is drawn into the narrow portions of the tapers and aerosol of the liquid is emitted from the wide portions of the tapers.

212. The apparatus of claim 209, wherein the aerosolization element has a curvature.

213. The apparatus of claim 209, wherein the aerosolization element comprises a dome shape.

214. The apparatus of claim 209, wherein the vibratory aerosolization element comprises palladium.

215. The apparatus of claim 209, wherein the vibratory aerosolization element consists of palladium.

216. The apparatus of claim 209, wherein the vibratory aerosolization element consists essentially of palladium.

217. The apparatus of claim 209, wherein the controller is configured to provide aerosol for substantially an entire inhalation phase.

218. The apparatus of claim 209, wherein the controller is configured to provide aerosol for an interval comprising a portion of an inhalation phase beginning at the start of the inhalation phase and ending prior to completion of the inhalation phase.

219. The apparatus of claim 209, wherein the controller is configured to provide aerosol for an interval comprising a portion of an inhalation phase beginning at a first predetermined point after the start of the inhalation phase and ending at a second predetermined point prior to completion of the inhalation phase.

220. The apparatus of claim 209, wherein the controller is configured to provide aerosol for an interval comprising a portion of an inhalation phase beginning at a first predetermined point after the start of the inhalation phase and ending at the end of the inhalation phase.

221. The apparatus of claim 209, wherein the controller is configured to provide aerosol for an interval comprising a portion of an inhalation phase and a portion of an exhalation phase, beginning at a first predetermined point after the start and before the end of the inhalation phase and ending after the end of the inhalation phase during the exhalation phase.

222. The apparatus of claim 209, wherein the controller is configured to provide aerosol for an interval comprising a portion of the inhalation phase and an entire exhalation phase, beginning at a first predetermined point after the start and before the end of the inhalation phase and ending at the end of the exhalation phase.

223. The apparatus of claim 209, wherein the controller is configured to provide aerosol for an interval comprising an entire exhalation phase.

224. The apparatus of claim 209, wherein the controller is configured to provide aerosol for an interval comprising a portion of an exhalation phase, after the start of the exhalation phase and ending to completion of the exhalation phase.

225. The apparatus of claim 209, wherein the controller is configured to provide aerosol for an interval comprising a portion of an exhalation phase and a portion of the successive inhalation phase, beginning after the start of the exhalation phase and ending during the successive inhalation phase.

226. The apparatus of claim 209, wherein the controller may select an interval from the group of intervals comprising:

an entire inhalation phase;

a portion of an inhalation phase beginning at the start of the inhalation phase and ending prior to completion of the inhalation phase;

a portion of an inhalation phase beginning at a first predetermined point after the start of the inhalation phase and ending at a second predetermined point prior to completion of the inhalation phase;

a portion of an inhalation phase beginning at a first predetermined point after the start of the inhalation phase and ending at the end of the inhalation phase;

a portion of an inhalation phase and a portion of an exhalation phase, beginning at a first predetermined point after the start and before the end of the inhalation phase and ending after the end of the inhalation phase during the exhalation phase;

a portion of the inhalation phase and an entire exhalation phase, beginning at a first predetermined point after the start and before the end of the inhalation phase and ending at the end of the exhalation phase;

an entire exhalation phase;

a portion of an exhalation phase, after the start of the exhalation phase and ending to completion of the exhalation phase; and

a portion of an exhalation phase and a portion of the successive inhalation phase, beginning after the start of the exhalation phase and ending during the successive inhalation phase.

227. The apparatus of claim 226, wherein the portions of the inhalation phases and the portions of the exhalation phases are predetermined percentages of the respective phase.

228. The apparatus of claim 209, wherein the vibratory aerosolization element is configured to produce a low velocity aerosol cloud.

229. The apparatus of claim 228, wherein the low velocity cloud is of such a velocity so as to remain substantially within the inlet portion of a Y connector, such Y connector comprising an inlet portion, an endotracheal tube portion and an outlet portion when the nebulizer is positioned to emit aerosol into the inlet portion of a Y connector.

230. The apparatus of claim 209, wherein the vibratory aerosolization element may be replaced by a second apertured vibratory element having a plurality of apertures of a different size than the apertures of the first apertured vibratory aerosolization element.

231. The apparatus of claim 210, further comprising:

a vibratory element in mechanical communication with the aerosolization element;

wherein the aerosolization element is vibrated by vibration of the vibratory element.

232. The apparatus of claim 231,

further comprising an aerosol actuator;

wherein the aerosolization element and the vibratory element are each mechanically connected to the aerosol actuator.

233. The apparatus of claim 232, wherein the aerosolization element, the aerosol actuator and the vibratory element may be removed as a unit and replaced with a second assembly comprising a second aerosolization element, a second aerosol actuator and a second vibratory element;

wherein the apertures of the second aerosolization element have a substantially uniform exit diameter that is different from the substantially uniform exit diameter of the apertures of the first aerosolization clement.

234. A method of varying the particle size of nebulized fluid administered to a patient comprising:

providing a first aerosolization element having a first face, a second face and a plurality of apertures therethrough, the apertures having a substantially uniform exit diameter at the second face, such that a liquid that may be provided at the first face may be drawn through the apertures and emitted from the aperture exits at the second face as a mist having a first particle size distribution;

replacing the first aerosolization element with a second aerosolization element having a first face, a second face and a plurality of apertures therethrough, the apertures having a substantially uniform exit diameter at the second face that is different form the substantially uniform exit diameter of the apertures of the first aerosolization element, such that a liquid that may be provided at the first face of the second aerosolization element may be drawn through the apertures thereof and be emitted from the aperture exits at the second face as a mist having a second particle size distribution different than the first particle size distribution.

235. The method of claim 234 further comprising:

vibrating the second aerosolization element to draw liquid into the apertures at the first face thereof and emit the liquid from the apertures at the second face thereof as a mist.

236. A nebulizing device for providing aerosol to a ventilated patient, comprising:

a breathing circuit comprising a Y connector, the Y connector having an inlet portion, an endotracheal tube portion and an outlet portion, the inlet portion providing air from the ventilator to the patient via the endotracheal tube portion and the outlet portion providing an exhaust route,

a nebulizer, comprising an apertured vibratory aerosolization element;

a controller for controlling the vibratory operation of the apertured vibratory aerosolization element;

wherein the vibratory aerosolization element is configured to vibrate in such a manner so as to provide an aerosol cloud that travels substantially no further into the breathing circuit than the inlet portion of the Y connector when there is no inspiratory air flowing through the inlet portion.

237. The apparatus of claim 236, wherein the apertured vibratory aerosolization element may be replaced by a second apertured vibratory element having a plurality of apertures of a different size than the apertures of the first apertured vibratory aerosolization element.

238. A system for providing nebulized fluid to a ventilated patient, comprising:

a ventilator,

a breathing circuit,

a vibratory aerosolization element having a first face, a second face and a plurality of apertures therethrough;

a controller configured to control vibration of the vibratory aerosolization element,

wherein the controller may be configured to vibrate the vibratory aerosolization element during a selected interval of a breathing cycle.

239. The system of claim 238, wherein the selected interval is based on a predetermined point of the breath cycle provided by the ventilator.

240. The system of claim 239, wherein the predetermined point is the commencement of an inhalation phase provided by the ventilator

241. The system of claim 239, wherein the interval begins at a first predetermined point in the breathing cycle and ends at a second predetermined point in the breathing cycle.

242. A system for providing nebulized fluid to a patient receiving air from a ventilator, comprising:

a breathing circuit comprising a Y connector, the Y connector comprising an inlet portion, an endotracheal tube portion and an outlet portion;

a nebulizer positioned to provide nebulized fluid into the inlet portion of the Y connector, the nebulizer comprising;

a vibratory aerosolization element having a first face, a second face and a plurality of apertures therethrough;

wherein the vibratory element may be caused to vibrate at least in part by an electrical signal in a manner so as to draw fluid into the apertures at the first face thereof and emit the fluid as a low velocity nebulized cloud from the second face, and wherein the force of the emitted cloud is small enough that substantially no aerosol is lost through the outlet portion when there is no inspiratory flow through the inlet portion.

243. The apparatus of claim 242, wherein substantially no aerosol travels into the endotracheal tube portion of the Y connector when there is no inspiratory flow through the inlet portion.

244. A system for providing nebulized fluid to a patient receiving air from a ventilator, comprising:

a breathing circuit comprising a Y connector, the Y connector comprising an inlet portion, an endotracheal tube portion and an outlet portion;

a nebulizer positioned to provide nebulized fluid into the inlet portion of the Y connector, the nebulizer comprising;

a vibratory aerosolization element having a first face, a second face and a plurality of apertures therethrough;

wherein the vibratory element may be caused to vibrate at least in part by an electrical signal in a manner so as to draw fluid into the apertures at the first face thereof and emit the fluid as a low velocity nebulized cloud from the second face, and wherein the force of the emitted cloud is small enough that substantially all of the cloud may travel no further than the inlet portion of the Y connector when there is no inspiratory flow through the inlet portion.

245. A method of providing nebulized fluid to a patient receiving air from a ventilator, comprising:

providing a ventilator,

providing a breathing circuit to connect the ventilator to a patient, the breathing circuit comprising a Y connector, the Y connector comprising an inlet portion, an endotracheal portion and an outlet portion,

providing a nebulizer positioned to provide aerosol into the inlet portion of the Y connector, the nebulizer comprising a vibratory aerosolization element, the vibratory aerosolization element operable in part by an electronic signal;

providing an electronic signal that causes the aerosolization element to vibrate in such a manner as to deliver a cloud of mist into the inlet portion of the inlet portion during an interval in which there is substantially no inhalation flow through the inlet portion, such that the cloud remains substantially within the inlet portion;

providing an inhalation flow from the ventilator in such a manner as to sweep substantially the entire cloud of nebulized fluid through the endotracheal tube portion to the patient substantially upon the commencement of the inhalation flow.

246. A method of providing nebulized fluid to a neonatal patient receiving air from a ventilator, comprising:

providing a ventilator,

providing a breathing circuit to connect the ventilator to a patient, the breathing circuit comprising a Y connector, the Y connector comprising an inlet portion, an endotracheal portion and an outlet portion,

providing a nebulizer positioned to provide aerosol into the inlet portion of the Y connector, the nebulizer comprising a vibratory aerosolization element, the vibratory aerosolization element operable in part by an electronic signal;

providing an electronic signal that causes the aerosolization element to vibrate in such a manner as to deliver a cloud of mist into the inlet portion of the inlet portion during an interval in which there is substantially no inhalation flow through the inlet portion, such that the cloud remains substantially within the inlet portion;

providing an inhalation flow from the ventilator in such a manner as to sweep substantially the entire cloud of nebulized fluid through the endotracheal tube portion to the patient substantially upon the commencement of the inhalation flow.

247. A method for providing nebulized fluid to a patient receiving air from a ventilator, comprising:

providing an aerosolization element;

providing a controller configured to operate the aerosolization element;

providing at least one algorithm that the controller may follow to determine a point to begin operation of the aerosolization element;

wherein the controller can operate the aerosolization element independent of the instantaneous state of the ventilator.

248. The method of claim 247, further comprising:

the controller receiving a signal from the ventilator which the controller may use in executing the algorithm.

249. A system for providing nebulized fluid to a patient receiving air from a ventilator, comprising:

an aerosolization element;

a controller configured to operate the aerosolization element;

at least one algorithm accessible by the controller that the controller may follow to determine a point to begin operation of the aerosolization element;

wherein the controller can operate the aerosolization element independent of the instantaneous state of the ventilator.

250. The system of claim 249, further comprising a signal receiver by which the controller may receive a signal from the ventilator.

251. A system for providing aerosol into a ventilator circuit, comprising;

a ventilator capable of providing at least one cycle of inhalation air;

a ventilator circuit comprising an inhalation tube, and exhalation tube and an intubation tube, and a Y connector therebetween;

a sensor configured to monitor a point within an inhalation cycle of the ventilator;

a nebulizer comprising a microprocessor, the microprocessor configured to calculate an inhalation profile based on the sensed point of operation of the ventilator, the microprocessor further configured to follow at least one algorithm for operating the nebulizer based on an inhalation profile,

wherein the algorithm is configured to provide a point for the commencement of aerosolization and a point for the cessation of aerosolization.

252. The system of claim 251, wherein the of aerosolization and the point for cessation of aerosolization are not designed to coincide with the commencement of an inhalation phase and the cessation of an inhalation phase of an inhalation cycle provided by the nebulizer.

254. The system of claim 251, wherein the point for commencement.

255. The system of claim 251, wherein the point for commencement of aerosolization and the point for cessation of aerosolization are chosen to maximize actual inhalation of aerosolized liquid.

256. The system of claim 255, wherein the point for commencement of aerosolization is a point following the completion of a predetermined portion of the inhalation phase of the inhalation cycle

257. The system of claim 256, wherein the point for cessation of aerosolization is a point prior to a predetermined portion of the inhalation phase of the inhalation cycle has occurred.

258. The system of claim 255, wherein the point for cessation of aerosolization is a point following the completion of a predetermined portion of the subsequent exhalation phase of the inhalation cycle.

259. The system of claim 255, wherein the point for commencement of aerosolization is a point following the completion of a predetermined portion of the exhalation phase of the inhalation cycle.

260. The system of claim 259, wherein the point for cessation of aerosolization is a point following the completion of a predetermined portion of the exhalation phase of the inhalation cycle

261. The system of claim 259, wherein the point for cessation of aerosolization is a point following the completion of a predetermined portion of the subsequent inhalation phase of the subsequent inhalation cycle.

262. The system of claim 252, wherein the nebulizer is configured to provide a mist propelled at low velocity such that between about 50% and about 90% of the mist generated in an inhalation cycle may occupy a portion of the ventilator circuit between the T and the Y connectors without any force of air.

263. The system of claim 252, wherein the nebulizer is configured to provide a mist propelled at low velocity such that between about 60% and about 80% of the mist generated in an inhalation cycle may occupy a portion of the ventilator circuit between the T and the Y connectors without any force of air.

264. The system of claim 252, wherein the nebulizer is configured to provide a mist propelled at low velocity such that between about 65% and about 75% of the mist generated in an inhalation cycle may occupy a portion of the ventilator circuit between the T and the Y connectors without any force of air.

265. A method of providing aerosol into the circuit of a ventilator over a predetermined portion of an inhalation cycle independent of the instantaneous point in the inhalation cycle provided by the ventilator, comprising:

providing a ventilator circuit;

providing an aerosolization element positioned to provide aerosol into the ventilator circuit;

providing a controller to control the operation of the aerosolization element;

providing an algorithm accessible by the controller;

providing a reference signal from the ventilator;

formulating an operation sequence for the controller to power the aerosolization element and to stop powering the aerosolization element, the formulation comprising utilizing the reference signal in combination with the algorithm to determine a time interval for providing aerosol into the ventilator circuit; and

providing aerosol into the ventilator circuit according the operation sequence.

266. The method of claim 265, wherein the detection comprises detecting a pressure drop within the ventilation circuit.

267. The method of claim 265, wherein the algorithm is designed to have the controller start aerosol production based on the completion of a predetermined portion of an inhalation phase of an inhalation cycle.

268. The method of claim 265, wherein the algorithm is designed to have the controller stop aerosol production based on the completion of a predetermined portion of the inhalation phase of the inhalation cycle.

269. The method of claim 265, wherein the algorithm is designed to have the controller start aerosol production based on the completion of a predetermined portion of an exhalation phase of an inhalation cycle.

270. The method of claim 265, wherein the algorithm is designed to have the controller stop aerosol production based on the completion of a predetermined portion of the exhalation phase of the inhalation cycle.

271. A system for providing nebulized fluid to a person receiving air from a ventilator, comprising:

an aerosolization element;

a controller configured to cause the aerosol generator to begin aerosol production at a first predetermined time in a breathing cycle and to stop production of aerosol at a second predetermined time in the breathing cycle;

an algorithm accessible by the controller, the algorithm configured to allow the controller to calculate an operating sequence based at least in part on the identity of a drug to be aerosolized.

272. The system of claim 271, further comprising a nebule containing drug to be aerosolized.

273. The system of claim 272, wherein the nebule comprises a marker identifying the drug therein.

274. The system of claim 273, further comprising a reader that can read the identifying marker and provide the identity of the drug to the controller.

275. The system of claim 274, wherein the drug is an antibiotic.

276. The system of claim 275, wherein the antibiotic is an aminoglycoside.

277. The system of claim 276, wherein the aminoglycoside is amikacin.

278. The system of claim 271, wherein the operation sequence calls for aerosol production to begin substantially at the start of an inhalation provided by the ventilator and for aerosol production to at a point at which substantially half of the inhalation phase has been completed.

279. The system of claim 276, wherein the operation sequence calls for aerosol production to begin substantially at the start of an inhalation provided by the ventilator and for aerosol production to at a point at which substantially half of the inhalation phase has been completed.

280. The system of claim 274, wherein the drug is an antibody.

281. They system of claim 280, wherein the drug is IgG.

282. A method of providing a particular drug as a nebulized fluid to a patient receiving air from a ventilator, the method comprising:

providing an aerosolization element;

providing a controller that is configured to cause the aerosol generator to begin aerosol production at a first predetermined time in a breathing cycle and to stop production of aerosol at a second predetermined time in the breathing cycle;

providing an algorithm accessible by the controller, the algorithm configured to allow the controller to calculate an operating sequence based at least in part on the identity of a drug to be aerosolized.

283. The method of claim 282, further comprising providing a nebule that contains a drug to be aerosolized.

284. The method of claim 283, wherein the nebule comprises a marker identifying the drug therein.

285. The method of claim 284, further comprising:

providing a reader that can read the identifying marker and that can provide the identity of the drug to the controller.

286. The method of claim 285, further comprising:

having the reader read the identity of the drug;

having the controller receive the identity of the drug; and

having the controller establish an operating sequence based at least in part on the identity of the drug that it received.

287. The method of claim 286, wherein the drug is an antibiotic.

288. The method of claim 287, wherein the antibiotic is an aminoglycoside.

289. The method of claim 288, wherein the aminoglycoside is amikacin.

290. The method of claim 282, wherein the operation sequence calls for aerosol production to begin substantially at the start of an inhalation provided by the ventilator and for aerosol production to at a point at which substantially half of the inhalation phase has been completed.

291. The method of claim 289, wherein the operation sequence calls for aerosol production to begin substantially at the start of an inhalation provided by the ventilator and for aerosol production to at a point at which substantially half of the inhalation phase has been completed.

292. The method of claim 282, wherein the drug is an antibody.

293. They method of claim 292, wherein the drug is IgG.

294. A system for providing nebulized fluid to a person receiving air from a ventilator, comprising:

an aerosolization element;

a controller configured to cause the aerosol generator to begin aerosol production at a first predetermined time in a breathing cycle and to stop production of aerosol at a second predetermined time in the breathing cycle;

wherein the controller is configured to adjust the time interval of aerosol production based on a change in the breath rhythm of a ventilated patient.