Efficiency of budesonide delivery via a mesh nebulizer in an in‐vitro neonatal ventilator model

Abstract

Objective To determine the delivery efficiency of budesonide aerosol via a mesh nebulizer in a neonatal ventilator model. Design/Method In an in‐vitro ventilated neonatal model, budesonide suspension was administered using a mesh nebulizer. A collection filter was placed distal to the endotracheal tube and budesonide captured by the filter was measured using UV spectroscopy. The ventilator was, in turn, either on high frequency or conventional ventilation mode and the nebulizer was placed either proximal (close to the endotracheal tube) or distal (between the wet side of humidifier and the inspiratory circuit). Each combination (nebulizer position and ventilation mode) to assess budesonide delivery was tested five times. Results Overall delivery of budesonide to the distal end of the endotracheal tube a small percentage of the total dose administered. The deposition with conventional ventilation was 2.12% (±1.06) and 1.26% (±0.27), with proximal and distal placement of the nebulizer, respectively. With high‐frequency ventilation, the deposition percentages were 1.82% (±0.82) and 1.69% (±0.23), with proximal and distal nebulizer placement, respectively. Conclusion Only a small percentage of administered budesonide is delivered to the distal endotracheal tube, irrespective of ventilation mode, and nebulizer placement.

Handling budesonide nebules to maximize the dispensed drug

“…It is unlikely that we will ever return to exclusively inperson care. 3,4 Thus, there is a critical, but currently unstudied, need to understand caregivers' attitudes toward virtual food allergy management. To address this knowledge gap, we performed a mixedmethods study in which we sought to examine caregivers' views on virtual food allergy care.…”

“…as nebulized therapy, intervention relies on several aspects, including dispensing the initial drug dose. [2][3][4] An additional therapeutic use of budesonide is for nasal irrigation, which has become a popular method for delivering corticosteroids to paranasal sinuses. This treatment approach has been established in multiple level 1 and 2 studies, with an aggregate evidence level A.…”

Pediatric Pulmonology 2020 year in review: Asthma

“…With more use of these nebulizers, one group sought to characterize the efficiency of aerosolized budesonide particle deposition using a VMN in a ventilated neonatal lung model. 17 They chose this model given the large number of infants with bronchopulmonary dysplasia who are treated with inhaled budesonide. They connected a ventilator, with a VMN in the circuit, to an endotracheal tube with a collection filter at the tip to measure deposited budesonide particles.…”

In Vitro Evaluation of a Vibrating-Mesh Nebulizer Repeatedly Use over 28 Days

“…The advantages of vibrating-mesh nebulizers over the jet and other ultrasonic nebulizers include less noise, effective concentration, and minimal temperature changes that make it suitable for temperature-sensitive drugs. Vibrating-mesh nebulizers are predominantly used in clinical trials involving mechanical ventilation and newly developed medications [ 2 , 3 , 5 , 6 , 7 , 8 ].…”

“…Particle sizes (measured using eFlow, Pari Ltd., Starnberg, Germany) were very similar; however, aerosol generation was inconsistent owing to clogging by drug. There are several papers by investigators, as well as the manufacturer demonstrating device performance in a number of clinical applications with a wide range of formulations [ 3 , 5 , 6 , 7 , 8 ]. The intellectual property portfolio is largely focused on physical attributes of the technology, such as the number, shape and configuration of apertures, and the composition of both the mesh, the key components of the aerosol generator, as well as the design and function of the medical reservoir.…”