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https://www.readbyqxmd.com/read/29114011/albuterol-delivery-efficiency-in-a-pediatric-model-of-noninvasive-ventilation-with-double-limb-circuit
#1
Jeanne Velasco, Ariel Berlinski
BACKGROUND: Noninvasive ventilation (NIV) is used to treat respiratory failure in patients with concomitant need for aerosol delivery. Limited pediatric data are available on aerosol delivery efficiency, and none at all regarding aerosol delivery efficiency with a double-limb circuit. We compared the effect of position in the double-limb ventilator circuit, types of nebulizer, and ventilator settings on aerosol delivery efficiency in a pediatric model of NIV. We hypothesized that placing a vibrating mesh nebulizer at the ventilator and using the highest inspiratory pressures would increase aerosol delivery efficiency...
November 7, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29066385/nebulized-coenzyme-q10-nanosuspensions-a-versatile-approach-for-pulmonary-antioxidant-therapy
#2
Irene Rossi, Fabio Sonvico, Jason McConville, Francesca Rossi, Eleonore Fröhlich, Sarah Zellnitz, Alessandra Rossi, Elena Del Favero, Ruggero Bettini, Francesca Buttini
Coenzyme Q10 (CoQ10) is an antioxidant substance indicated as a dietary supplement which has been proposed as adjuvant in the treatment of cardiovascular disorders and cancer for its protective and immunostimulating activities. The aim of this work was the production by high-pressure homogenization, characterization and stability investigation of three different CoQ10 nanosuspensions designed to be administered to the lungs by nebulization. Three surfactants, i.e. Lecithin, PEG32 Stearate and Vitamin-E TPGS, were selected to stabilize CoQ10 formulations...
October 21, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29054517/size-distribution-of-salbutamol-ipratropium-aerosols-produced-by-different-nebulizers-in-the-absence-and-presence-of-heat-and-humidification
#3
Ssu-Han Yang, Tsung-Ming Yang, Hui-Ling Lin, Ying-Huang Tsai, Tien-Pei Fang, Gwo-Hwa Wan
BACKGROUND: Few studies have evaluated the size distribution of inhaled and exhaled aerosolized drugs, or the effect of heated humidification on particle size and lung deposition. The present study evaluated these aspects of bronchodilator (salbutamol/ipratropium) delivery using a lung model in the absence and presence of heat and humidification. METHODS: We positioned filters to collect and measure the initial drug, inhaled drug, and exhaled drug. Particle size distribution was evaluated using an 8-stage Marple personal cascade impactor with 0...
October 17, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29035132/hybrid-lipid-polymer-nanoparticles-for-pulmonary-delivery-of-sirna-development-and-fate-upon-in-vitro-deposition-on-the-human-epithelial-airway-barrier
#4
Ivana d'Angelo, Gabriella Costabile, Estelle Durantie, Paola Brocca, Valeria Rondelli, Annapina Russo, Giulia Russo, Agnese Miro, Fabiana Quaglia, Alke Petri-Fink, Barbara Rothen-Rutishauser, Francesca Ungaro
BACKGROUND: Nowadays, the downregulation of genes involved in the pathogenesis of severe lung diseases through local siRNA delivery appears an interesting therapeutic approach. In this study, we propose novel hybrid lipid-polymer nanoparticles (hNPs) consisting of poly(lactic-co-glycolic) acid (PLGA) and dipalmitoyl phosphatidylcholine (DPPC) as siRNA inhalation system. METHODS: A panel of DPPC/PLGA hNPs was prepared by emulsion/solvent diffusion and fully characterized...
October 16, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28923758/methacholine-challenge-testing-a-novel-method-for-measuring-pd20
#5
Beth E Davis, Samuel K Simonson, Christianne M Blais, Donald W Cockcroft
BACKGROUND: New guidelines for methacholine challenge testing recommend reporting the test outcome as dose rather than concentration. Jet nebulizers have historically been used for methacholine challenge testing, but much of the weight loss, often (incorrectly) referred to as aerosol output, is actually evaporation. The Wright nebulizer is well characterized and still widely used, but its availability is unclear, and it is nondisposable. We developed a novel method using a vibrating mesh nebulizer (Solo)...
September 18, 2017: Chest
https://www.readbyqxmd.com/read/28882385/lung-deposition-and-systemic-bioavailability-of-different-aerosol-devices-with-and-without-humidification-in-mechanically-ventilated-patients
#6
Islam O F Moustafa, Mohammed R A-A Ali, Moataz Al Hallag, Hoda Rabea, James B Fink, Patricia Dailey, Mohamed E A Abdelrahim
BACKGROUND: During mechanical ventilation medical aerosol delivery has been reported to be upto two fold greater with dry inhaled gas than with heated humidity. Urine levels at 0.5 h post dose (URSAL0.5%) has been confirmed as an index of lung deposition and 24 h (URSAL24%) as index of systemic absorption. Our aim was to determine the effect of humidification and aerosol device type on drug delivery to ventilated patients using urine levels. METHODS: In a randomized crossover design, 36 (18female) mechanically ventilated patients were assigned to one of three groups...
November 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28874611/how-should-aerosols-be-delivered-during-invasive-mechanical-ventilation
#7
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
https://www.readbyqxmd.com/read/28859915/viral-bronchiolitis-in-young-infants-new-perspectives-for-management-and-treatment
#8
REVIEW
Mauricio T Caballero, Fernando P Polack, Renato T Stein
OBJECTIVE: The aim of this review was to address advances in management and treatment of acute viral bronchiolitis in infants. SOURCES: A systematic review search was made including all articles published in English between 2010 and 2017, and available in the electronic databases PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) and specialized register of the Acute Respiratory Infections Group (Cochrane review group). The following MESH terms in English were included, using different Boolean operators for the search strategy: "bronchiolitis, viral," "diagnosis," "epidemiology," "etiology," "therapy," "virology," "prevention and control," "respiratory syncytial virus, human...
November 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28829202/effect-of-heat-moisture-exchanger-on-aerosol-drug-delivery-and-airway-resistance-in-simulated-ventilator-dependent-adults-using-jet-and-mesh-nebulizers
#9
Arzu Ari, Truong Dang, Fahad H Al Enazi, Mohammed M Alqahtani, Abdulrahman Alkhathami, Rowaida Qoutah, Ahmad S Almamary, James B Fink
BACKGROUND: Placement of a heat moisture exchanger (HME) between aerosol generator and patient has been associated with greatly reduced drug delivery. The purpose of this study was to evaluate the effect of filtered and nonfiltered HMEs placed between nebulizer and patient on aerosol deposition and airway resistance (Raw) in simulated ventilator-dependent adults. METHODS: An in vitro lung model was developed to simulate a mechanically ventilated adult (Vt 500 mL, RR 15/min, and PEEP 5 cmH2O, using two inspiratory flow rates 40 and 50 L/min) using an intubated adult manikin with an endotracheal tube (8 mmID)...
August 22, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28813621/improvement-of-an-in-vitro-model-to-assess-delivered-dose-and-particle-size-for-a-vibrating-mesh-nebulizer-during-mechanical-ventilation
#10
Nani Kadrichu, Derek Daniher
BACKGROUND: In an in vitro model of mechanical ventilation with gravity-dependent filter position we observed artificially high delivered doses resulting from liquid droplet collection and precipitation of aerosolized drug. We sequentially modified the model to obtain accurate reproducible measurements of delivered dose and particle size at endotracheal tube exit. METHODS: Stepwise changes in the model included (1) altering the endotracheal tube position to a gravity-independent position, (2) adding fluid traps, (3) humidifying air near the test lung, and (4) simplifying test lung and filters...
August 16, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28813613/methacholine-challenge-comparison-of-airway-responsiveness-produced-by-a-vibrating-mesh-nebulizer-versus-a-jet-nebulizer
#11
Christianne M Blais, Donald W Cockcroft, Justine Veilleux, Marie-Ève Boulay, Louis-Philippe Boulet, Gail M Gauvreau, Tara X Scime, Richard M Watson, Paul M O'Byrne, Beth E Davis
BACKGROUND: The latest methacholine challenge testing (MCT) guidelines published by the European Respiratory Society recommend the characterization of nebulizers before their use in clinics and research. Such investigations are necessary for accurately determining the provocative dose of methacholine causing a 20% fall in FEV1 (PD20) delivered by a given device. The standard English Wright (Wright) jet nebulizer recommended in the 1999 guidelines by the American Thoracic Society has become difficult to obtain and possesses some characteristics that complicate the calculation of dose delivery from this device (e...
August 16, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28782710/use-of-nebulized-milrinone-in-cardiac-surgery-comparison-of-vibrating-mesh-and-simple-jet-nebulizers
#12
Paul Gavra, Maxime Laflamme, André Y Denault, Yves Théoret, Louis P Perrault, France Varin
Cardiopulmonary bypass triggers an ischemia-reperfusion injury with endothelial dysfunction in the pulmonary circulation which can result in pulmonary hypertension. Inhaled milrinone reduces this reperfusion phenomenon and two methods commonly available for administering it are simple jet and vibrating mesh nebulizations. However, neither their generated milrinone particle size profiles, nor their ability to aid endothelial relaxation have been compared. Simple jet and vibrating mesh particle size distributions of milrinone were verified through cascade impaction and their efficacy was tested on a cardiopulmonary bypass (CPB) swine model...
October 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28741229/inhaled-antimicrobials-for-ventilator-associated-pneumonia-practical-aspects
#13
Garyphallia Poulakou, Dimitrios K Matthaiou, David P Nicolau, Georgios Siakallis, George Dimopoulos
Positive experience with inhaled antibiotics in pulmonary infections of patients with cystic fibrosis has paved the way for their utilization in mechanically ventilated, critically ill patients with lower respiratory tract infections. A successful antibiotic delivery depends upon the size of the generated particle and the elimination of drug impaction in the large airways and the ventilator circuit. Generated droplet size is mainly affected by the type of the nebulizer employed. Currently, jet, ultrasonic, and vibrating mesh nebulizers are marketed; the latter can deliver optimal antibiotic particle size...
July 24, 2017: Drugs
https://www.readbyqxmd.com/read/28720675/the-effect-of-nebulizer-position-on-aerosolized-epoprostenol-delivery-in-an-adult-lung-model
#14
Allison C Anderson, Meagan N Dubosky, Kelly A Fiorino, Vanessa Quintana, Carl A Kaplan, David L Vines
BACKGROUND: Aerosolized epoprostenol is an alternative for inhaled nitric oxide in the management of pulmonary arterial hypertension and possibly acute hypoxemia. Our objective was to determine differences in drug deposition based on different nebulizer positions in the ventilator circuit, using a vibrating mesh nebulizer. METHODS: An 8.0-mm inner diameter endotracheal tube (ETT) was connected to a training test lung, compliance of 30 mL/cm H2O, with a collecting filter placed at the ETT-test lung junction...
November 2017: Respiratory Care
https://www.readbyqxmd.com/read/28683216/pulmonary-drug-delivery-following-continuous-vibrating-mesh-nebulization-and-inspiratory-synchronized-vibrating-mesh-nebulization-during-noninvasive-ventilation-in-healthy-volunteers
#15
Jean-Bernard Michotte, Enrico Staderini, Anne-Sophie Aubriot, Emilie Jossen, Jonathan Dugernier, Giuseppe Liistro, Gregory Reychler
BACKGROUND: 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...
July 6, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28647745/early-halt-of-a-randomized-controlled-study-with-3-hypertonic-saline-in-acute-bronchiolitis
#16
Ania Carsin, Emilie Sauvaget, Violaine Bresson, Karine Retornaz, Maria Cabrera, Elisabeth Jouve, Romain Truillet, Emmanuelle Bosdure, Jean-Christophe Dubus
BACKGROUND: Albeit not recommended because of contradictory results, nebulized 3% hypertonic saline is widely used for treating acute viral bronchiolitis. Whether clinical differences may be attributed to the type of nebulizer used has never been studied. OBJECTIVES: By modifying the amount of salt deposited into the airways, the nebulizer characteristics might influence clinical response. METHODS: A prospective, randomized, controlled trial included infants hospitalized in a French university hospital for a first episode of bronchiolitis...
June 24, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28646325/anti-tuberculosis-bacteriophage-d29-delivery-with-a-vibrating-mesh-nebulizer-jet-nebulizer-and-soft-mist-inhaler
#17
Nicholas B Carrigy, Rachel Y Chang, Sharon S Y Leung, Melissa Harrison, Zaritza Petrova, Welkin H Pope, Graham F Hatfull, Warwick J Britton, Hak-Kim Chan, Dominic Sauvageau, Warren H Finlay, Reinhard Vehring
PURPOSE: To compare titer reduction and delivery rate of active anti-tuberculosis bacteriophage (phage) D29 with three inhalation devices. METHODS: Phage D29 lysate was amplified to a titer of 11.8 ± 0.3 log10(pfu/mL) and diluted 1:100 in isotonic saline. Filters captured the aerosolized saline D29 preparation emitted from three types of inhalation devices: 1) vibrating mesh nebulizer; 2) jet nebulizer; 3) soft mist inhaler. Full-plate plaque assays, performed in triplicate at multiple dilution levels with the surrogate host Mycobacterium smegmatis, were used to quantify phage titer...
June 23, 2017: Pharmaceutical Research
https://www.readbyqxmd.com/read/28627376/inhaled-salbutamol-dose-delivered-by-jet-nebulizer-vibrating-mesh-nebulizer-and-metered-dose-inhaler-with-spacer-during-invasive-mechanical-ventilation
#18
Muhammad H E ElHansy, Marina E Boules, Assem Fouad Mohamed El Essawy, Mohamed Bakry Al-Kholy, Maha M Abdelrahman, Amira S A Said, Raghda R S Hussein, Mohamed E Abdelrahim
BACKGROUND: Patient receiving invasive mechanical ventilation (IMV) may benefit from medical aerosol, but guidance on dosing with different aerosol devices is limited to in-vitro studies. The study was designed to compare aerosol delivery with five different types of aerosol generators during IMV. METHOD: In randomized design, 60 (30 female) mechanically ventilated chronic obstructive pulmonary disease (COPD) patients were assigned to one of 5 groups. Groups 1-4 received 5000 μg salbutamol using Aerogen Pro (PRO), Aerogen Solo (SOLO), NIVO vibrating mesh and jet nebulizers (JN), respectively, while group 5 received 800 μg (8 puffs) of salbutamol via metered dose inhaler with AeroChamber-MV (MDI-AC)...
August 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28588117/aerosol-delivery-through-adult-high-flow-nasal-cannula-with-heliox-and-oxygen
#19
Patricia A Dailey, Robert Harwood, Kyle Walsh, James B Fink, Tina Thayer, Greg Gagnon, Arzu Ari
BACKGROUND: Heliox (helium-oxygen mixture) has been shown to reduce turbulence and improve aerosol delivery in a range of clinical settings. We questioned whether heliox as compared with oxygen via high-flow nasal cannula (HFNC) would affect aerosol delivery. We hypothesized that heliox would have a significant effect on aerosol delivery as compared with oxygen with both quiet and distressed breathing patterns. METHODS: A vibrating mesh nebulizer was placed at the inlet of a humidifier via HFNC with small adult cannula distal to the heated-wire circuit with prongs placed into simulated nares with a T-shaped trap and absolute filter connected to a breath simulator set to adult quiet and distressed breathing parameters...
June 6, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28470113/nebulized-drug-delivery-in-respiratory-medicine-what-does-the-future-hold
#20
John N Pritchard
In the later half of the 20th century, nebulized therapy was in decline, but in the 21st century the prospects for the expanded use of nebulized therapy within respiratory medicine look bright. The advent of mesh nebulizers, which combine the universal applicability of the nebulizer in the treatment of all respiratory patients with the convenience of portable inhaler use, is ideally timed to capitalize on the forecast of increased numbers of patients who will require nebulized therapy in the future. This special report will highlight some of the opportunities that the development of mesh nebulizers presents in the field of respiratory medicine...
June 2017: Therapeutic Delivery
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