Lung Deposition of Air Pollutants and Inhaled Drugs in Patients with Chronic Obstructive Pulmonary Disease (COPD) and Those on Non-Invasive Ventilation (NIV): Is It Still Challenging?

Abstract

Chronic Obstructive Pulmonary Disease (COPD) ranks among the leading causes of mortality worldwide, particularly in low- and middle-income nations. The primary risk factors for the development of COPD are tobacco smoking and the inhalation of pollutants from both indoor and outdoor sources. The exacerbation of COPD resulting from the mentioned factors significantly affects the patient’s quality of life and is often associated with frequent hospitalizations and the potential need for mechanical ventilation. Regarding drug administration, the inhalation route is the most efficient way to deliver drugs directly to the lungs and target organs, while reducing systematic side effects. When evaluating the deposition of inhaled drugs in the lungs, the most frequently employed techniques are in vivo, scintigraphy, and functional respiratory imaging (FRI). Aside from bronchodilator therapy and corticosteroids, antibiotics, anti-inflammatory drugs, vaccines, and monoclonal antibodies are currently being studied for their potential benefits, particularly in patients receiving invasive or non-invasive mechanical ventilation.