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Continuous nebulizer

Paul Gavra, André Y Denault, Yves Théoret, Louis P Perrault, France Varin
OBJECTIVES: Milrinone pulmonary administration is used currently for the treatment of pulmonary hypertension. Several methods are available: simple jet nebulization, vibrating mesh nebulization, intratracheal instillation, and intratracheal atomization. The aim of this study was to explore the concentration-effect relationship of milrinone for each of these methods. DESIGN: Observational open-label pharmacokinetic/pharmacodynamics cohort study. SETTING: Single-center, hospital animal laboratory...
January 31, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Matthew L Bradshaw, Alexandre Déragon, Pramod Puligandla, Guillaume Emeriaud, Anne-Marie Canakis, Patricia S Fontela
OBJECTIVE: To describe management practices and the factors guiding admission and treatment decisions for viral bronchiolitis across Canadian pediatric intensive care units (PICUs). DESIGN: Cross-sectional survey. SETTING: Canadian PICUs. SUBJECTS: Pediatric intensivists. MEASUREMENTS AND MAIN RESULTS: A survey using two case scenarios (non-intubated vs intubated patients) was developed using focus groups and a literature review...
February 27, 2018: Pediatric Pulmonology
Reiko Sakurai, Cindy Lee, Humphrey Shen, Alan J Waring, Frans J Walther, Virender K Rehan
BACKGROUND: Despite improvements in perinatal care, bronchopulmonary dysplasia (BPD) in extremely premature infants has not decreased. Postnatal surfactant therapy provides symptomatic relief from respiratory distress syndrome, but does not translate into a reduction in BPD. Therefore, the search for effective interventions to prevent BPD continues. OBJECTIVES: Since PPAR-γ agonists have been demonstrated to promote neonatal lung maturation and injury repair, we hypothesized that a formulation of a PPAR-γ agonist, pioglitazone (PGZ) and a synthetic lung surfactant (a surfactant protein B peptide mimic, B-YL) combined would stimulate lung maturation and block hyperoxia-induced neonatal lung injury more effectively than either modality alone...
February 9, 2018: Neonatology
Richard W Chapman, Zhili Li, Michel R Corboz, Helena Gauani, Adam J Plaunt, Donna M Konicek, Franziska G Leifer, Charles E Laurent, Han Yin, Dany Salvail, Chad Dziak, Walter R Perkins, Vladimir Malinin
INS1009 is a long acting pulmonary vasodilator prodrug of treprostinil (TRE) that is formulated in a lipid nanoparticle for inhaled delivery by nebulization. This study examined the ability of INS1009 to inhibit vasoconstriction in the pulmonary vasculature of rats and dogs and the extent to which local activity within the lung contributes to its activity. Rats received a single dose of INS1009 by nose-only inhalation or were given a continuous intravenous (i.v.) infusion of TRE, followed by an i.v. challenge of the thromboxane mimetic pulmonary vasoconstrictor U46619 and the increase in pulmonary arterial pressure (PAP) was measured...
February 5, 2018: Pulmonary Pharmacology & Therapeutics
S Keisin Wang, Linden A Green, Ashley R Gutwein, Alok K Gupta, Clifford M Babbey, Raghu L Motaganahalli, Andres Fajardo, Michael P Murphy
OBJECTIVE: Previous in vitro and animal studies have suggested that osteopontin (OPN), an inflammatory extracellular matrix protein, is involved in the formation and growth of abdominal aortic aneurysms (AAAs). However, the mechanism by which this occurs continues to be nebulous. The relationship between OPN and inflammation-suppressing lymphocytes present in the human AAA condition was investigated and presented herein. METHODS: Serum OPN concentrations were measured in healthy, risk factor-matched non-AAA and AAA patients by enzyme-linked immunosorbent assay (ELISA)...
February 3, 2018: Journal of Vascular Surgery
Leo Pekka Malmberg, Paula Kauppi, Mika J Mäkelä
Recent technical recommendations on bronchial challenge testing aim at standardized assessment of provocative dose of causing 20% decrease in FEV1 (PD20). The aim of this study was to investigate the effect of mode of nebulization on the output of a computerized dosimeter (APS) and to compare PD20 obtained by two different dosimetric systems in vivo. The output of the APS system was tested during continuous nebulization, and using simulated breaths, for intermittent actuations with four different durations...
January 17, 2018: Clinical Physiology and Functional Imaging
Drayton A Hammond, Laura Finlay
Hypertriglyceridemia is the third most common worldwide cause of acute pancreatitis. Resolving the underlying etiology is imperative for optimal management. This is especially true with regard to hypertriglyceridemia, as this etiology may cause more severe acute pancreatitis and worse symptoms than other causes of the disease. Many pharmacological treatment options for hypertriglyceridemia-induced acute pancreatitis (HTGP) have been proposed; however, the safety and efficacy for specific treatment regimens remain nebulous...
November 2017: Hospital Pharmacy
Bat-El Bar-Aluma, Ori Efrati, Horacio Kaufmann, Jose-Alberto Palma, Lucy Norcliffe-Kaufmann
BACKGROUND: Chronic lung disease is a leading cause of premature death in patients with familial dysautonomia (FD). A significant number of patients have obstructive airway disease, yet it is not known whether this is pharmacologically reversible. METHODS: We conducted a double-blind, placebo-controlled, randomized clinical trial comparing the beta 2 agonist albuterol with the muscarinic blocker ipratropium bromide in patients homozygous for the IKBKAP founder mutation...
February 2018: Lung
Zhiyue Li, Fengzhi Wu, Haozhen Shao, Yu Zhang, Angran Fan, Feng Li
Objective: To study the effect of the essential oils of Citrus sinensis L., Mentha piperita L., Syzygium aromaticum L., and Rosmarinus officinalis L. on physical exhaustion in rats. Methods: Forty-eight male Wistar rats were randomly divided into a control group, a fatigue group, an essential oil mixture (EOM) group, and a peppermint essential oil (PEO) group. Loaded swimming to exhaustion was used as the rat fatigue model. Two groups were nebulized with EOM and PEO after swimming, and the others were nebulized with distilled water...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
Georgios I Ioannou, Tamsyn Montagnon, Dimitris Kalaitzakis, Spiros A Pergantis, Georgios Vassilikogiannakis
A series of hydroxycyclopent-2-enones and methoxycyclopent-2-enones have been synthesized in a single operation from simple furan substrates using an innovative continuous flow nebulizer system (NebPhotOX). Photooxygenation of the furan substrates takes place in an aerosol within the NebPhotOX system.
December 13, 2017: Organic & Biomolecular Chemistry
Thamina Acter, Seulgidaun Lee, Eunji Cho, Maeng-Joon Jung, Sunghwan Kim
In this study, continuous in-source hydrogen/deuterium exchange (HDX) atmospheric pressure photoionization (APPI) mass spectrometry (MS) with continuous feeding of D2O was developed and validated. D2O was continuously fed using a capillary line placed on the center of a metal plate positioned between the UV lamp and nebulizer. The proposed system overcomes the limitations of previously reported APPI HDX-MS approaches where deuterated solvents were premixed with sample solutions before ionization. This is particularly important for APPI because solvent composition can greatly influence ionization efficiency as well as the solubility of analytes...
October 27, 2017: Journal of the American Society for Mass Spectrometry
Banu Bayar, Nurcan Uman Kutkan, Esra Şafak Yılmaz, Çiğdem Tolun, Engin Doğan, Enver Kağan Atikeler, Elif Hilal Vural, Salih Babacan, Nurgül Karabekmez, Aslıhan Beyan, İsmail Mert Vural, İpek Kıvılcım Oğuzülgen, Güven Bektemür, Simten Malhan, Rabia Kahveci, Sedat Altın, Ali Alkan, Hakan Eroğlu, Hakkı Gürsöz
BACKGROUND: With the rise in life expectancy, the burden of chronic diseases, including obstructive pulmonary diseases, has increased throughout the world. OBJECTIVES: To evaluate the sales trends of inhaler pharmaceuticals. METHODS: The changes in box sales and sales amounts (in Turkish lira) of inhaler pharmaceuticals during the period 1998 to 2015 were examined and sales were projected for the next 3 years. Pharmaceuticals were classified according to form and pharmacological groups...
September 2017: Value in Health Regional Issues
Igor Pujalté, Alessandra Serventi, Alexandra Noël, Denis Dieme, Sami Haddad, Michèle Bouchard
Nanoparticles (NPs) can be released in the air in work settings, but various factors influence the exposure of workers. Controlled inhalation experiments can thus be conducted in an attempt to reproduce real-life exposure conditions and assess inhalation toxicology. Methods exist to generate aerosols, but it remains difficult to obtain nano-sized and stable aerosols suitable for inhalation experiments. The goal of this work was to characterize aerosols of titanium dioxide (TiO₂) NPs, generated using a novel inhalation system equipped with three types of generators-a wet collision jet nebulizer, a dry dust jet and an electrospray aerosolizer-with the aim of producing stable aerosols with a nano-diameter average (<100 nm) and monodispersed distribution for future rodent exposures and toxicological studies...
July 1, 2017: Toxics
Gyu-Hong Shim
To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recently, a meta-analysis of large controlled trials comparing conventional methods and nasal CPAP suggested that CPAP decreased the risk of the combined outcome of bronchopulmonary dysplasia or death...
September 2017: Korean Journal of Pediatrics
Sunil Kumar Garg, Pragya Garg, Nidhi Anchan, Ashish Jaiswal
Iatrogenic pneumothorax refers to the pneumothorax generated after diagnostic or therapeutic procedure. We report the case of a 40-year-old male who had bilateral simultaneous iatrogenic pneumothorax with pneumomediastinum leading to cardiac arrest situation, due to wrong placement of nebulization kit in spontaneously breathing intubated patient. We report this case for its rarity, due to the critical importance of this cause as a etiology of bilateral simultaneous iatrogenic pneumothorax leading to cardiac arrest situation, and need to understand the importance of continuous training and stress of emergency environment...
September 2017: Indian Journal of Critical Care Medicine
Mårten Svensson, Elna Berg, Jolyon Mitchell, Dennis Sandell
Determination of fine droplet dose with preparations for nebulization, currently deemed to be the metric most indicative of lung deposition and thus in vivo responses, involves combining two procedures following practice as described in the United States Pharmacopeia and the European Pharmacopeia. Delivered dose (DD) is established by simulating tidal breathing at the nebulizer, collecting the medication on a filter downstream of the nebulizer mouthpiece/facemask. Fine droplet fraction (FDF<x μm) is determined separately using a cooled cascade impactor operated at 15 L/min...
September 5, 2017: AAPS PharmSciTech
Rajiv Dhand
The delivery of aerosols to mechanically ventilated patients presents unique challenges and differs from inhaled drug delivery in spontaneously breathing patients in several respects. Successful aerosol delivery during invasive mechanical ventilation requires careful consideration of a host of factors that influence the amount of drug inhaled by the patient. Pressurized metered-dose inhalers and nebulizers (jet, ultrasonic, and vibrating mesh) are the most commonly used aerosol delivery devices in these patients, although other delivery devices, such as dry powder inhalers, soft mist inhalers, and intratracheal nebulizing catheters, could also be adapted for in-line use...
October 2017: Respiratory Care
Edward Kerwin, James F Donohue, Thomas Goodin, Robert Tosiello, Alistair Wheeler, Gary T Ferguson
BACKGROUND: SUN-101 is a combination of glycopyrrolate delivered through an innovative, electronic nebulizer, intended for the treatment of patients with COPD. The objective of this study was to assess the efficacy and safety of this new drug device combination. METHODS: Replicate Phase III randomized, double-blind, placebo-controlled studies were conducted to evaluate the efficacy and safety of glycopyrrolate solution administered by an investigational eFlow(®) Closed System (eFlow(®) CS) nebulizer in subjects with moderate-to-very-severe COPD, including those with continued background use of a long-acting beta2-agonist ± inhaled corticosteroid and/or history of cardiovascular (CV) disease...
July 19, 2017: Respiratory Medicine
Eduardo R DA Silva, Humberto R Bizzo, Patrícia D Fernandes, Valdir F DA Veiga, Suzana G Leitão, Danilo R DE Oliveira
The bioavailability, toxicity, and therapeutic efficacy of a drug is directly related to its administration route. The pulmonary route can be accessed by inhalation after fumigation, vaporization or nebulization. Thus, pharmacological and toxicological evaluation accessed by an apparatus specifically designed and validated for this type of administration is extremely important. Based on pre-existing models, an inhalation chamber was developed. This presents a central structure with five animal holders. The nebulized air passes directly and continuously through these holders and subsequently to an outlet...
July 2017: Anais da Academia Brasileira de Ciências
Jennifer Orr Vincent, Huay-Ying Lo, Susan Wu
BACKGROUND: Viral bronchiolitis is a common cause of hospitalization in young children, but despite a variety of therapeutic options, the mainstay of treatment remains supportive care. OBJECTIVE: To examine the most recent evidence for supportive care measures and pharmacologic options in the treatment of bronchiolitis in the hospital setting. METHOD: MEDLINE search with expert medical librarian for publications on management and therapies for bronchiolitis...
2017: Reviews on Recent Clinical Trials
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