<i>In Vitro</i>Analysis of Nasal Interface Options for High-Efficiency Aerosol Administration to Preterm Infants

Howe, Connor A.; Momin, Mohammad A.M.; Bass, Karl; Aladwani, Ghali; Bonasera, Serena; Hindle, Michael; Longest, P. Worth

doi:10.1089/jamp.2021.0057

Cited by 8 publications

(3 citation statements)

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“…Filters added after the nasopharynx region can also be utilized to estimate the inhaled dose. An example of such an experiment is shown in Figure 8 [ 35 ]. An infant nose throat model was developed to quantify nose to lung deposition of a trans-nasal in-line dry powder inhalation (DPI).…”

Section: Cast Applicationsmentioning

confidence: 99%

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In Vitro Anatomical Models for Nasal Drug Delivery

Williams

Suman

2022

Pharmaceutics

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Nasal drug delivery has been utilized for locally acting diseases for decades. The nose is also a portal to the systemic circulation and central nervous system (CNS). In the age of SARS-CoV2, the development of nasal sprays for vaccination and prophylaxis of respiratory diseases is increasing. As the number of nasal drug delivery applications continue to grow, the role of targeted regional deposition in the nose has become a factor is nasal drug development. In vitro tools such as nasal casts help facilitate formulation and product development. Nasal deposition has been shown to be linked to pharmacokinetic outcomes. Developing an understanding of the complex nasal anatomy and intersubject variability can lead to a better understanding of where the drug will deposit. Nasal casts, which are replicas of the human nasal cavity, have evolved from models made from cadavers to complex 3D printed replicas. They can be segmented into regions of interest for quantification of deposition and different techniques have been utilized to quantify deposition. Incorporating a nasal cast program into development can help differentiate formulations or physical forms such as nasal powder versus a liquid. Nasal casts can also help develop instructions for patient use to ensure deposition in the target deposition site. However, regardless of the technique used, this in vitro tool should be validated to ensure the results reflect the in vivo situation. In silico, CFD simulation or other new developments may in future, with suitable validation, present additional approaches to current modelling, although the complexity and wide degree of variability in nasal anatomy will remain a challenge. Nonetheless, nasal anatomical models will serve as effective tools for improving the understanding of nasal drug delivery.

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Section: Cast Applicationsmentioning

confidence: 99%

“…The inset shows an expanded view of the air-jet DPI, illustrating internal components, including the aerosolization chamber. NT, nose-throat [ 35 ].…”

Section: Figurementioning

confidence: 99%

In Vitro Anatomical Models for Nasal Drug Delivery

Williams

Suman

2022

Pharmaceutics

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“…Dual prongs at an insertion depth of 2 mm are probably best with upper airway losses of 15–20% ( 44 ). Various studies describe ingenious modifications of the nasal interface to improve aerosol delivery during nCPAP support, but these have not been tested in vivo yet ( 68 ).…”

Section: Nebulizationmentioning

confidence: 99%

Aerosol Delivery of Lung Surfactant and Nasal CPAP in the Treatment of Neonatal Respiratory Distress Syndrome

Walther

Waring²

2022

Front. Pediatr.

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After shifting away from invasive mechanical ventilation and intratracheal instillation of surfactant toward non-invasive ventilation with nasal CPAP and less invasive surfactant administration in order to prevent bronchopulmonary dysplasia in preterm infants with respiratory distress syndrome, fully non-invasive surfactant nebulization is the next Holy Grail in neonatology. Here we review the characteristics of animal-derived (clinical) and new advanced synthetic lung surfactants and improvements in nebulization technology required to secure optimal lung deposition and effectivity of non-invasive lung surfactant administration. Studies in surfactant-deficient animals and preterm infants have demonstrated the safety and potential of non-invasive surfactant administration, but also provide new directions for the development of synthetic lung surfactant destined for aerosol delivery, implementation of breath-actuated nebulization and optimization of nasal CPAP, nebulizer circuit and nasal interface. Surfactant nebulization may offer a truly non-invasive option for surfactant delivery to preterm infants in the near future.

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