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Valved Holding Chambers

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https://www.readbyqxmd.com/read/28846482/valved-holding-chambers-and-in-vitro-metered-dose-inhaler-performance-effects-of-flow-rate-and-inhalation-delay
#1
Xiaofei Liu, Changning Guo, Badrul Chowdhury, Peter Starke, Susan Limb, Prasad Peri, Alan Schroeder, William Doub
BACKGROUND: Multiple factors may influence the performance of a metered dose inhaler (MDI) when used with a valved holding chamber (VHC or "spacer"). METHODS: Andersen Cascade Impactor measurements were conducted for three MDI products and two different VHCs using a specially designed system that accommodated variable delay times between MDI actuation and introduction of the aerosol into the impactor, and allowed reduced flow through the VHC while the impactor was operated at 28...
August 28, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28684363/investigation-of-multiphase-multicomponent-aerosol-flow-dictating-pmdi-spacer-interactions
#2
Saurabh Sarkar, S Prasad Peri, Bodhisattwa Chaudhuri
The use of Pressurized metered dose inhalers (pMDIs) for the treatment of asthma and other chronic obstructive pulmonary diseases is frequently associated with breath-actuation synchronization problems and poor pulmonary delivery, particularly amongst the pediatric and geriatric population groups. Spacers, or Valved Holding Chambers (VHCs), are frequently used to address these problems. However, the performance of spacers with different pMDIs is also highly variable and needs to be investigated. The purpose of the current study is to develop a computational fluid dynamics (CFD) model which can characterize multiphase multicomponent aerosol flow issuing from a commercial suspension-based pMDI into a spacer...
July 4, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28670327/asthma-pressurised-metered-dose-inhaler-performance-propellant-effect-studies-in-delivery-systems
#3
William F S Sellers
BACKGROUND: Current pressurised metered dose asthma inhaler (pMDI) propellants are not inert pharmacologically as were previous chlorofluorocarbons, have smooth muscle relaxant' partial pressure effects in the lungs and inhaled hydrofluoroalkane 134a (norflurane) has anaesthetic effects. Volumes of propellant gas per actuation have never been measured. METHODS: In-vitro studies measured gas volumes produced by pMDIs on air oxygen (O2) levels in valved holding chambers (VHC) and the falls in O2% following actuation into lung ventilator delivery devices...
2017: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/28611228/effect-of-interval-between-actuations-of-albuterol-hydrofluoroalkane-pressurized-metered-dose-inhalers-on-their-aerosol-characteristics
#4
Ariel Berlinski, David Pennington
BACKGROUND: Albuterol hydrofluoroalkane (HFA) either alone or with a valved holding chamber is used to treat bronchoconstriction. Delays between actuation and inhalation are common. Currently, the recommended interval between actuations of an albuterol HFA is 60 s. Using a shorter interval when multiple actuations are ordered will improve productivity in the hospital setting. METHODS: We studied aerosol characteristics of albuterol HFA (Ventolin, ProAir, and Proventil) with a cascade impactor calibrated at 30 L/min...
June 13, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28510491/short-term-growth-during-treatment-with-inhaled-fluticasone-propionate-formoterol-fluticasone-and-beclomethasone-treatment
#5
Ole D Wolthers, Ainslee Moore, Sabine Mersmann, Sanjeeva Dissanayake
BACKGROUND: Fluticasone propionate/formoterol (FP/FORM) is a pressurized metered-dose inhaler (pMDI; Flutiform(®)) approved for use in adolescents and adults and under development for pediatric use. OBJECTIVE: To compare short-term growth in asthmatic children treated with FP/FORM, FP pMDI with valved holding chamber, and beclomethasone dipropionate (BDP) in a breath-actuated device. METHODS: Children with persistent asthma (n = 48; 5 to <12 years) participated in an assessor-blinded, randomized, three-way crossover trial with run in, wash out, and active treatment periods, each of 2 weeks duration...
May 16, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28450164/a-novel-approach-to-study-the-pmdi-plume-using-an-infrared-camera-and-to-evaluate-the-aerodynamic-properties-after-varying-the-time-between-actuations
#6
Nitesh K Kunda, Julia Hautmann, Sebastián E Godoy, Patricia Marshik, Ramesh Chand, Sanjay Krishna, Pavan Muttil
Plume characteristics, such as temperature and velocity, emitted from pMDIs could significantly affect the dose delivered to the lung. Currently, high speed cameras and thermocouples are used separately to evaluate these parameters. We used a low-noise infrared camera to evaluate both the temperature and velocity of the emitted plume from pMDIs. Additionally, we investigated whether the fine particle fraction (FPF) is affected when time between actuations is varied. We tested three different albuterol sulfate pMDIs: ProAir(®) HFA, Proventil(®) HFA, and Ventolin(®) HFA...
April 24, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28427550/home-made-spacer-as-an-auxiliary-device-in-administration-of-beclomethasone-via-pressurized-metered-dose-inhaler-for-asthma-control-a-randomized-controlled-pragmatic-trial
#7
Deborah Schor, José Ângelo Rizzo, Decio Medeiros, Ana Carolina Dela Bianca, Almerinda Rego Silva, Carlos Nunes, Mário Morais-Almeida, Emanuel Sarinho
BACKGROUND: Holding chambers or spacers can enhance the efficacy of pressurized metered dose inhalers (pMDI) in delivering inhaled medications, as they reduce the need for hand-breath coordination and improve lower airways deposition. Nevertheless, their cost can be high for patients in low-income countries. OBJECTIVE: To compare asthma control achieved with beclomethasone-dipropionate administered through a hydrofluoroalkane-driven pMDI (BDp-pMDI) coupled to a home-made spacer (HmS) or to a valved commercial spacer (VCS) as auxiliary devices...
May 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28109120/real-time-3-dimensional-echocardiographic-assessment-of-effective-regurgitant-orifice-area-in-dogs-with-myxomatous-mitral-valve-disease
#8
A Tidholm, A Bodegård-Westling, K Höglund, J Häggström, I Ljungvall
BACKGROUND: Effective regurgitant orifice area (EROA), calculated from the vena contracta width (VCW) as the narrowest portion of the proximal regurgitant jet, might be used to estimate severity of mitral regurgitation. However, this simplified assumption only holds when the EROA is circular, which might not be true in dogs with myxomatous mitral valve disease (MMVD). HYPOTHESIS: Effective regurgitant orifice area in dogs with MMVD is noncircular, and using color Doppler real-time 3-dimensional (RT3D) echocardiography, measured EROA in the en face view will be significantly different from calculated EROA...
March 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/27977309/drug-delivery-in-asthmatic-children-following-coordinated-and-uncoordinated-inhalation-maneuvers-a-randomized-crossover-trial
#9
Ariel Berlinski, Dirk von Hollen, Ross H M Hatley, Lucy E A Hardaker, Kurt Nikander
BACKGROUND: Valved holding chambers (VHCs) are used in children to deliver pressurized metered dose inhalers (pMDI). In vitro data suggest that uncoordinated use decreases the amount of drug available for inhalation. We hypothesize that in an ex vivo study, the coordinated maneuver will deliver more drug than the uncoordinated one. PATIENTS AND METHODS: Thirty-two clinically stable asthmatic children, ages 5-8 years, completed the study. An aerosol filter was interposed between a small-volume nonelectrostatic VHC and a mouthpiece to capture the drug emitted by one puff of Flovent(®) 220 mcg during tidal breathing...
June 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/27822851/spect-ct-comparison-of-lung-deposition-using-a-system-combining-a-vibrating-mesh-nebulizer-with-a-valved-holding-chamber-and-a-conventional-jet-nebulizer-a-randomized-cross-over-study
#10
Jonathan Dugernier, Michel Hesse, Rita Vanbever, Virginie Depoortere, Jean Roeseler, Jean-Bernard Michotte, Pierre-François Laterre, François Jamar, Gregory Reychler
PURPOSE: To compare in vivo the total and regional pulmonary deposition of aerosol particles generated by a new system combining a vibrating-mesh nebulizer with a specific valved holding chamber and constant-output jet nebulizer connected to a corrugated tube. METHODS: Cross-over study comparing aerosol delivery to the lungs using two nebulizers in 6 healthy male subjects: a vibrating-mesh nebulizer combined with a valved holding chamber (Aerogen Ultra®, Aerogen Ltd...
November 7, 2016: Pharmaceutical Research
https://www.readbyqxmd.com/read/27613457/the-effect-of-a-holding-chamber-on-albuterol-metered-dose-inhaler-product-differences
#11
COMPARATIVE STUDY
Jennifer L H Johnson, Danielle Guthrie, Joel Hyde, Thomas Hanson, Kelly Karlage, Paul B Myrdal
BACKGROUND: Three albuterol sulfate metered-dose inhaled (MDI) products (Ventolin HFA, Proventil HFA, and ProAir HFA) are marketed in the United States to provide the same total dose of albuterol sulfate. However, it is widely known that the fine particle dose (<5 μm) is the portion of the particle distribution that actually reaches the lungs and provides therapeutic benefit. OBJECTIVE: To examine the differences in particle size between products and how a valved holding chamber (VHC) can mitigate possible adverse effects...
September 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27547548/computational-fluid-dynamics-modelling-of-left-valvular-heart-diseases-during-atrial-fibrillation
#12
Stefania Scarsoglio, Andrea Saglietto, Fiorenzo Gaita, Luca Ridolfi, Matteo Anselmino
BACKGROUND: Although atrial fibrillation (AF), a common arrhythmia, frequently presents in patients with underlying valvular disease, its hemodynamic contributions are not fully understood. The present work aimed to computationally study how physical conditions imposed by pathologic valvular anatomy act on AF hemodynamics. METHODS: We simulated AF with different severity grades of left-sided valvular diseases and compared the cardiovascular effects that they exert during AF, compared to lone AF...
2016: PeerJ
https://www.readbyqxmd.com/read/27194239/enhancing-asthma-medication-delivery-spacers-and-valved-holding-chambers
#13
Sally Schoessler, Tonya Winders
Asthma is one of the most prevalent chronic diseases managed by school nurses, and its management often includes the administration of bronchodilators delivered via a metered dose inhaler (MDI). The use of an MDI requires coordination and mastery of steps that must be performed correctly and in the proper order. These steps are greatly enhanced, especially in the pediatric population, through the use of medical devices-spacers and valved holding chambers. The purpose of this article is to review the rationale and implications for the use of these devices in the school setting...
July 2016: NASN School Nurse
https://www.readbyqxmd.com/read/27167376/density-gradient-mediated-band-extraction-of-leukocytes-from-whole-blood-using-centrifugo-pneumatic-siphon-valving-on-centrifugal-microfluidic-discs
#14
David J Kinahan, Sinéad M Kearney, Niamh A Kilcawley, Philip L Early, Macdara T Glynn, Jens Ducrée
Here we present retrieval of Peripheral Blood Mononuclear Cells by density-gradient medium based centrifugation for subsequent analysis of the leukocytes on an integrated microfluidic "Lab-on-a-Disc" cartridge. Isolation of white blood cells constitutes a critical sample preparation step for many bioassays. Centrifugo-pneumatic siphon valves are particularly suited for blood processing as they function without need of surface treatment and are 'low-pass', i.e., holding at high centrifugation speeds and opening upon reduction of the spin rate...
2016: PloS One
https://www.readbyqxmd.com/read/27006348/oronasal-and-tracheostomy-delivery-of-soft-mist-and-pressurized-metered-dose-inhalers-with-valved-holding-chamber
#15
Ariel Berlinski, Brandy Cooper
BACKGROUND: Some pediatric tracheostomized patients who receive inhaled drugs undergo decannulation, and it is unknown whether the dose has to be adjusted. Pressurized metered-dose inhalers (pMDIs) and soft mist inhalers (SMIs) used with valved holding chambers (VHCs) made of non-electrostatic material are available. We hypothesized that using an SMI and changing the delivery route from tracheostomy to oronasal would increase lung dose. METHODS: Four units of a metallic VHC were studied with albuterol hydrofluoroalkane (pMDI) and albuterol/ipratropium bromide with an SMI using an anatomically correct in vitro model of a 5-y-old spontaneously breathing tracheostomized child...
July 2016: Respiratory Care
https://www.readbyqxmd.com/read/26762338/a-multi-laboratory-in-vitro-study-to-compare-data-from-abbreviated-and-pharmacopeial-impactor-measurements-for-orally-inhaled-products-a-report-of-the-european-aerosol-group-epag
#16
MULTICENTER STUDY
Steven C Nichols, Jolyon P Mitchell, Dennis Sandell, Patrik U Andersson, Manfred Fischer, Markus Howald, Roy Pengilley, Phillip Krüger
Fine particle dose (FPD) is a critical quality attribute for orally inhaled products (OIPs). The abbreviated impactor measurement (AIM) concept simplifies its measurement, provided there is a validated understanding of the relationship with the full resolution pharmacopoeial impactor (PIM) data for a given product. This multi-center study compared fine particle dose determined using AIM and PIM for five dry powder inhaler (DPIs) and two pressurized metered-dose inhaler (pMDI) products, one of which included a valved holding chamber (VHC)...
December 2016: AAPS PharmSciTech
https://www.readbyqxmd.com/read/26491563/a-rationale-for-going-back-to-the-future-use-of-disposable-spacers-for-pressurised-metered-dose-inhalers
#17
REVIEW
Mark Sanders, Ronald Bruin
The introduction of pressurised metered dose inhalers (MDIs) in the mid-1950s completely transformed respiratory treatment. Despite decades of availability and healthcare support and development of teaching aids and devices to promote better use, poor pMDI user technique remains a persistent issue. The main pMDI user aid is the spacer/valved holding chamber (VHC) device. Spacer/chamber features (size, shape, configuration, construction material, and hygiene considerations) can vie with clinical effectiveness (to deliver the same dose as a correctly used pMDI), user convenience, cost, and accessibility...
2015: Pulmonary Medicine
https://www.readbyqxmd.com/read/26210342/leap-a-randomized-controlled-trial-of-a-lay-educator-inpatient-asthma-education-program
#18
Jessica L Rice, Kristen M Matlack, Marsha D Simmons, Jonathan Steinfeld, Margaret A Laws, Mark E Dovey, Robyn T Cohen
OBJECTIVE: To evaluate the impact of LEAP, a volunteer-based, inpatient asthma education program for families of inner-city children with asthma. METHODS: 711 children ages 2-17 years admitted with status asthmaticus were randomized to receive usual care or usual care plus a supplemental education intervention. Both groups completed a baseline interview. Trained volunteer lay educators conducted individualized bedside education with the intervention group. Primary outcome was attendance at a post-hospitalization follow-up visit 7-10 days after discharge...
June 29, 2015: Patient Education and Counseling
https://www.readbyqxmd.com/read/26098994/in-vitro-determination-of-respimat-%C3%A2-dose-delivery-in-children-an-evaluation-based-on-inhalation-flow-profiles-and-mouth-throat-models
#19
Deborah Bickmann, Wolfgang Kamin, Ashish Sharma, Herbert Wachtel, Petra Moroni-Zentgraf, Stefan Zielen
BACKGROUND: Aerosol therapy in young children can be difficult. A realistic model based on handling studies and in vitro investigations can complement clinical deposition studies and be used to enable dose-to-the-lung (DTL) predictions. METHODS: Predictions on dose delivery to the lung were based on (1) representative inhalation flow profiles from children enrolled in a Respimat(®) handling study, (2) in vitro measurement of the fine-particle DTL using mouth-throat models derived from nuclear magnetic resonance/computed tomography (NMR/CT) scans of children, and (3) a mathematical model to predict the tiotropium DTL...
June 22, 2015: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/26081179/a-randomized-controlled-trial-of-2-inhalation-methods-when-using-a-pressurized-metered-dose-inhaler-with-valved-holding-chamber
#20
RANDOMIZED CONTROLLED TRIAL
Divya Stephen, Manju Vatsa, Rakesh Lodha, S K Kabra
BACKGROUND: Information on the comparative efficacy of single deep breathing versus tidal breathing for inhaled asthma medications is limited, although such information can be of much use for the treatment of patients suffering from asthma. The objective of the present study was to compare the relative difference in improvement in peak expiratory flow (PEF) with single maximal inhalation with breath-holding versus 5 tidal breaths during inhalation of salbutamol from a pressurized metered dose inhaler (pMDI) with valved holding chamber (VHC) in children 5-15 y of age with asthma...
December 2015: Respiratory Care
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