Regional Ventilation Is the Main Determinant of Alveolar Deposition of Coarse Particles in the Supine Healthy Human Lung During Tidal Breathing

Sá, Rui Carlos; Zeman, Kirby L.; Bennett, William D.; Prisk, G. Kim; Darquenne, Chantal

doi:10.1089/jamp.2016.1336

Cited by 10 publications

(3 citation statements)

References 44 publications

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“…In the supine position in healthy spontaneously breathing humans, alveolar deposition of aerosols is seen to be directly proportional to ventilation with increased deposition in the lower lobes. 35 Our study shows similar deposition patterns in mechanically ventilated sheep.…”

Section: Discussionsupporting

confidence: 76%

Lung Pharmacokinetics of Tobramycin by Intravenous and Nebulized Dosing in a Mechanically Ventilated Healthy Ovine Model

et al. 2019

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Pseudomonasvaeruginosa and other Gram-negative organisms occurs frequently, 1 and is associated with significant morbidity and mortality. 2 Drugs from the aminoglycoside class, such as tobramycin, are recommended for the treatment of ventilator-associated pneumonia 3 and are effective against numerous Gram-negative organisms including P. aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumanii. 4 Despite systemic antibiotic therapy, therapeutic failure is common. 5 One reason for this lack of effect could be poor lung penetration due to low lung epithelial lining aBStraCt Background: Nebulized antibiotics may be used to treat ventilator-associated pneumonia. In previous pharmacokinetic studies, lung interstitial space fluid concentrations have never been reported. The aim of the study was to compare intravenous and nebulized tobramycin concentrations in the lung interstitial space fluid, epithelial lining fluid, and plasma in mechanically ventilated sheep with healthy lungs. Methods: Ten anesthetized and mechanically ventilated healthy ewes underwent surgical insertion of microdialysis catheters in upper and lower lobes of both lungs and the jugular vein. Five ewes were given intravenous tobramycin 400 mg, and five were given nebulized tobramycin 400 mg. Microdialysis samples were collected every 20 min for 8 h. Bronchoalveolar lavage was performed at 1 and 6 h. results: The peak lung interstitial space fluid concentrations were lower with intravenous tobramycin 20.2 mg/l (interquartile range, 12 mg/l, 26.2 mg/l) versus the nebulized route 48.3 mg/l (interquartile range, 8.7 mg/l, 513 mg/l), P = 0.002. For nebulized tobramycin, the median epithelial lining fluid concentrations were higher than the interstitial space fluid concentrations at 1 h (1,637; interquartile range, 650, 1,781, vs. 16 mg/l, interquartile range, 7, 86, P < 0.001) and 6 h (48, interquartile range, 17, 93, vs. 4 mg/l, interquartile range, 2, 9, P < 0.001). For intravenous tobramycin, the median epithelial lining fluid concentrations were lower than the interstitial space fluid concentrations at 1 h (0.

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Section: Discussionsupporting

confidence: 76%

Lung Pharmacokinetics of Tobramycin by Intravenous and Nebulized Dosing in a Mechanically Ventilated Healthy Ovine Model

et al. 2019

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“…3) Согласно клиническим рекомендациям при бронхиальной астме для доставки при помощи небулайзера используются бронходилататоры и глюкокортикостероиды [6]. Применение суспензии будесонида нацелено на быстрое и безопасное купирование дневных и ночных симптомов при обострении бронхиальной астмы [7][8][9][10][11].…”

Section: небулайзерная терапия при бронхиальной астмеunclassified

Place of nebulizer therapy in the treatment of bronchial asthma in children

Potapova

2022

Medicinskij sovet

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The review article presents an analysis of the data of foreign and domestic researchers characterizing the effectiveness of nebulizer therapy for bronchial asthma in children. The paper considers new data comparing the effectiveness of aerosol delivery devices. The advantage of inhalation therapy, which determines its widespread use in childhood, is its rapid delivery to the respiratory tract, high local and low systemic concentrations of the drug in target organs. Difficulties in observing the correct inhalation technique due to the difficulty of synchronizing inhalation and drug delivery, especially in young children, remain an urgent problem in the practice of treating chronic bronchopulmonary diseases, which leads to a severe and uncontrolled course, disability and adverse outcomes. The main disadvantage of ultrasonic nebulizers is the inactivation of suspensions, antibiotics and other drugs. Widely used jet nebulizers create noise during inhalation, have a large residual volume in the nebulizer chamber. In this regard, the improvement of delivery forms continues, taking into account the anatomical and physiological characteristics of the respiratory organs, the age of patients and comorbid conditions. The characteristics of the optimal inhaler include simplicity and ease of use, reliability, the possibility of effective inhalation of various drugs in combination with economical consumption. From this point of view, one of the universal means of transporting aerosols is membrane or electronic mesh (mesh) nebulizers, which provide excellent regional drug deposition in all age groups of children. The rapid achievement of clinical effect, compactness, mobility expand the possibilities of using mesh nebulizers at all levels of medical care.

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“…In healthy subjects, we showed that peripheral deposition and ventilation are proportional. (79) Combining quantitative MR ventilation imaging with particle deposition measurements has the potential to enable the early evaluation of inhalable drugs and contribute to optimization of their targeted delivery through manipulation of actionable characteristics such as resident gas properties, time/depth of inhalation, and particle size.…”

Section: Pulmonary Delivery Of Gasesmentioning

confidence: 99%

Pulmonary Delivery of Therapeutic and Diagnostic Gases

Zapol

Charles

Sá

et al. 2018

Journal of Aerosol Medicine and Pulmonary Drug Delivery

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The 21st Congress for the International Society for Aerosols in Medicine included, for the first time, a session on Pulmonary Delivery of Therapeutic and Diagnostic Gases. The rationale for such a session within ISAM is that the pulmonary delivery of gaseous drugs in many cases targets the same therapeutic areas as aerosol drug delivery, and is in many scientific and technical aspects similar to aerosol drug delivery. This article serves as a report on the recent ISAM congress session providing a synopsis of each of the presentations. The topics covered are the conception, testing, and development of the use of nitric oxide to treat pulmonary hypertension; the use of realistic adult nasal replicas to evaluate the performance of pulsed oxygen delivery devices; an overview of several diagnostic gas modalities; and the use of inhaled oxygen as a proton magnetic resonance imaging (MRI) contrast agent for imaging temporal changes in the distribution of specific ventilation during recovery from bronchoconstriction. Themes common to these diverse applications of inhaled gases in medicine are discussed, along with future perspectives on development of therapeutic and diagnostic gases.

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Regional Ventilation Is the Main Determinant of Alveolar Deposition of Coarse Particles in the Supine Healthy Human Lung During Tidal Breathing

Cited by 10 publications

References 44 publications

Lung Pharmacokinetics of Tobramycin by Intravenous and Nebulized Dosing in a Mechanically Ventilated Healthy Ovine Model

Lung Pharmacokinetics of Tobramycin by Intravenous and Nebulized Dosing in a Mechanically Ventilated Healthy Ovine Model

Place of nebulizer therapy in the treatment of bronchial asthma in children

Pulmonary Delivery of Therapeutic and Diagnostic Gases

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