Targeted Lung Deposition From Nebulization Is Not Improved in the Lateral Decubitus Position in Healthy Volunteers
| Autor: | Gregory Reychler, Giuseppe Liistro, François Jamar, Beatriz Herrero-Cortina, Marta San Miguel-Pagola, Michel Hesse, Vinciane Lecocq, Anne-Sophie Aubriot |
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| Přispěvatelé: | UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service de pneumologie, UCL - (SLuc) Service de médecine nucléaire, UCL - (SLuc) Service de pédiatrie générale |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Lung deposition Critical Care and Intensive Care Medicine Sitting Patient Positioning Nebulization 03 medical and health sciences 0302 clinical medicine Administration Inhalation Tidal Volume Lateral Decubitus Position Humans Medicine Aerosol deposition Lung Tidal volume Tomography Emission-Computed Single-Photon Cross-Over Studies Inhalation business.industry Gamma scintigraphy Nebulizers and Vaporizers Body position General Medicine Crossover study Healthy Volunteers Ventilation medicine.anatomical_structure 030228 respiratory system Breathing Technetium Tc 99m Pentetate Tomography X-Ray Computed Nuclear medicine business Delivery |
| Zdroj: | Respiratory care, Vol. 64, no.12, p. 1537-1544 (2019) |
| Popis: | BACKGROUND: Clinical benefits of inhaled therapies are related to the amount of drug deposited in the targeted area of the lung. Body positions that influence the distribution of lung ventilation should impact lung deposition of the nebulized drug. The aim of this study was to analyze the immediate effect of body position while the subject lies on his side (lateral decubitus) during nebulization on 3-dimensional total and regional lung deposition. METHODS: A randomized crossover trial was performed on healthy male volunteers without cardiovascular or pulmonary disease. A technetium-99m diethylenetriaminepentaacetic acid (99mTc-DTPA) solution (4 mL) was nebulized using an individual-controlled inhalation system in left lateral decubitus and sitting positions with a 96-h washout period (43 inspirations of 4 s [ie, drug delivered until second 3] with a tidal volume of 0.8 L and a low inspiratory flow (200 mL/s). Drug deposition was followed with the use of planar images and single-photon-emission computed tomography combined with low-resolution computed tomography. Total and regional depositions were the main outcomes. Penetration index was also considered. RESULTS: Six participants (26.8 ± 6.9 y old) were included. Total lung deposition tended to be higher in a sitting position than in a lateral decubitus position: 10.2 ± 0.9% of nominal dose (95% CI 9.1–11.3) vs 8.6 ± 1.4% of nominal dose (95% CI 6.8–10.4) (P = .09). The deposition was significantly reduced in the dependent (left) lung in the lateral decubitus position: 3.5 ± 0.7% of nominal dose (95% CI 2.6–4.3) vs 4.7 ± 0.3% of nominal dose (95% CI 4.3–5.0) (P = .03). Penetration index was only influenced by body position for the dependent (left) lung (P = .043). CONCLUSIONS: The total amount of drug delivered to the lungs during nebulization with an individual-controlled inhalation system tended to decrease when performed in the left lateral decubitus position. Moreover, contrary to the initial hypothesis, the deposition of particles in the dependent lung was not improved by the lateral decubitus position in this configuration. (ClinicalTrials.gov registration NCT02451501.) |
| Databáze: | OpenAIRE |
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