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Vibrating membrane devices deliver aerosols more efficient than standard devices: a study in a neonatal upper airway model


Tiemersma, Sybrich; Minocchieri, Stefan; van Lingen, Richard A; Nelle, Mathias; Devadason, Sunalene G (2013). Vibrating membrane devices deliver aerosols more efficient than standard devices: a study in a neonatal upper airway model. Journal of Aerosol Medicine and Pulmonary Drug Delivery, 26(5):280-286.

Abstract

BACKGROUND: Aerosol therapy in preterm infants is challenging, as a very small proportion of the drug deposits in the lungs.
AIM: Our aim was to compare efficiency of standard devices with newer, more efficient aerosol delivery devices.
METHODS: Using salbutamol as a drug marker, we studied two prototypes of the investigational eFlow(®) nebulizer for babies (PARI Pharma GmbH), a jet nebulizer (Intersurgical(®) Cirrus(®)), and a pressurized metered dose inhaler (pMDI; GSK) with a detergent-coated holding chamber (AeroChamber(®) MV) in the premature infant nose throat-model (PrINT-model) of a 32-week preterm infant (1,750 g). A filter or an impactor was placed below the infant model's "trachea" to capture the drug dose or particle size, respectively, that would have been deposited in the lung.
RESULTS: Lung dose (percentage of nominal dose) was 1.5%, 6.8%, and 18.0-20.6% for the jet nebulizer, pMDI-holding chamber, and investigational eFlow nebulizers, respectively (p<0.001). Jet nebulizer residue was 69.4% and 10.7-13.9% for the investigational eFlow nebulizers (p<0.001). Adding an elbow extension between the eFlow and the model significantly lowered lung dose (p<0.001). A breathing pattern with lower tidal volume decreased deposition in the PrINT-model and device residue (p<0.05), but did not decrease lung dose.
CONCLUSIONS: In a model for infant aerosol inhalation, we confirmed low lung dose using jet nebulizers and pMDI-holding chambers, whereas newer, more specialized vibrating membrane devices, designed specifically for use in preterm infants, deliver up to 20 times more drug to the infant's lung.

Abstract

BACKGROUND: Aerosol therapy in preterm infants is challenging, as a very small proportion of the drug deposits in the lungs.
AIM: Our aim was to compare efficiency of standard devices with newer, more efficient aerosol delivery devices.
METHODS: Using salbutamol as a drug marker, we studied two prototypes of the investigational eFlow(®) nebulizer for babies (PARI Pharma GmbH), a jet nebulizer (Intersurgical(®) Cirrus(®)), and a pressurized metered dose inhaler (pMDI; GSK) with a detergent-coated holding chamber (AeroChamber(®) MV) in the premature infant nose throat-model (PrINT-model) of a 32-week preterm infant (1,750 g). A filter or an impactor was placed below the infant model's "trachea" to capture the drug dose or particle size, respectively, that would have been deposited in the lung.
RESULTS: Lung dose (percentage of nominal dose) was 1.5%, 6.8%, and 18.0-20.6% for the jet nebulizer, pMDI-holding chamber, and investigational eFlow nebulizers, respectively (p<0.001). Jet nebulizer residue was 69.4% and 10.7-13.9% for the investigational eFlow nebulizers (p<0.001). Adding an elbow extension between the eFlow and the model significantly lowered lung dose (p<0.001). A breathing pattern with lower tidal volume decreased deposition in the PrINT-model and device residue (p<0.05), but did not decrease lung dose.
CONCLUSIONS: In a model for infant aerosol inhalation, we confirmed low lung dose using jet nebulizers and pMDI-holding chambers, whereas newer, more specialized vibrating membrane devices, designed specifically for use in preterm infants, deliver up to 20 times more drug to the infant's lung.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2013
Deposited On:10 Feb 2014 08:17
Last Modified:07 Dec 2017 08:37
Publisher:Mary Ann Liebert
ISSN:1941-2711
Additional Information:This is a copy of an article published in the Journal of Aerosol Medicine and Pulmonary Drug Delivery © 2013 copyright Mary Ann Liebert, Inc.; Journal of Aerosol Medicine and Pulmonary Drug Delivery is available online at: http://www.liebertonline.com.
Publisher DOI:https://doi.org/10.1089/jamp.2012.0993
PubMed ID:23273244

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