Pulmonary Drug Delivery Following Continuous Vibrating Mesh Nebulization and Inspiratory Synchronized Vibrating Mesh Nebulization During Noninvasive Ventilation in Healthy Volunteers
| Autor: | Emilie Jossen, Gregory Reychler, Anne-Sophie Aubriot, Jean-Bernard Michotte, Giuseppe Liistro, Enrico M. Staderini, Jonathan Dugernier |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Pharmaceutical Science Vibration 030226 pharmacology & pharmacy Young Adult 03 medical and health sciences Aerosol delivery Drug Delivery Systems 0302 clinical medicine Urinary excretion Double-Blind Method Administration Inhalation Healthy volunteers Positive airway pressure Humans Medicine Tissue Distribution Pharmacology (medical) Positive pressure ventilation Amikacin Lung Vibrating mesh nebulizer Aerosols Cross-Over Studies Noninvasive Ventilation business.industry Nebulizers and Vaporizers Middle Aged Anti-Bacterial Agents 030228 respiratory system Anesthesia Drug delivery Noninvasive ventilation business |
| Zdroj: | Journal of Aerosol Medicine and Pulmonary Drug Delivery. 31:33-41 |
| ISSN: | 1941-2703 1941-2711 |
| DOI: | 10.1089/jamp.2016.1339 |
| Popis: | A breath-synchronized nebulization option that could potentially improve drug delivery during noninvasive positive pressure ventilation (NIPPV) is currently not available on single-limb circuit bilevel ventilators. The aim of this study was to compare urinary excretion of amikacin following aerosol delivery with a vibrating mesh nebulizer coupled to a single-limb circuit bilevel ventilator, using conventional continuous (Conti-Neb) and experimental inspiratory synchronized (Inspi-Neb) nebulization modes.A crossover clinical trial involving 6 noninvasive ventilated healthy volunteers (mean age of 32.3 ± 9.5 y) randomly assigned to both vibrating mesh nebulization modes was conducted: Inspi-Neb delivered aerosol during only the whole inspiratory phase, whereas Conti-Neb delivered aerosol continuously. All subjects inhaled amikacin solution (500 mg/4 mL) during NIPPV using a single-limb bilevel ventilator (inspiratory positive airway pressure: 12 cm HThe total daily amount of amikacin excreted in the urine was significantly higher with Inspi-Neb (median: 44.72 mg; interquartile range [IQR]: 40.50-65.13) than with Conti-Neb (median: 40.07 mg; IQR: 31.00-43.73), (p = 0.02). The elimination rate constant of amikacin (indirect measure of the depth of drug penetration into the lungs) was significantly higher with Inspi-Neb (median: 0.137; IQR: 0.113-0.146) than with Conti-Neb (median: 0.116; IQR: 0.105-0.130), (p = 0.02). However, the mean pulmonary drug delivery rate, expressed as the ratio between total daily urinary amount of amikacin and nebulization time, was significantly higher with Conti-Neb (2.03 mg/min) than with Inspi-Neb (1.09 mg/min) (p 0.01).During NIPPV with a single-limb circuit bilevel ventilator, the use of inspiratory synchronized vibrating mesh nebulization may improve pulmonary drug delivery compared with conventional continuous vibrating mesh nebulization. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|