Abstract:
BACKGROUND:Mechanically ventilated patients commonly suffer from ventilator-associated pneumonia, hypoxemia, and other lower respiratory tract infection as a result of pathogen colonization and poor sputum clearance. Consequently, there is a high rate of morbidity and mortality in these patients. Dry powder mannitol increases sputum clearance, and therefore, we developed a system to administer it to mechanically ventilated patients without disconnection from the ventilator. METHODS:The inspiratory line from a ventilator was split by using a three-way valve into two parallel lines where one contains a humidifier for normal breathing cycle and the other line contains a dry powder inhaler (Osmohaler™). The inspiratory air went through the dry powder line and aerosolized the mannitol powder only when its administration to a patient is required. We determined the delivered dose and particle size distributions of emitted aerosols in vitro from 9.5 mm endotracheal and 7.5 mm tracheostomy tubes, with inspiratory airflow of 60, 70, and 80 L/min. RESULTS:This novel setup was able to deliver 24.6% ± 3.33% of the 160 mg loaded dose mannitol powder (4 × 40 mg capsules) and 26.7% ± 2.19% of the 320 mg dose (4 × 80 mg capsules) when the endotracheal tube was used. With the shorter tracheostomy tube, the delivery dose increased to 35.6% ± 3.01% and 39.5% ± 2.04% of the 160 and 320 mg doses, respectively. The volume median diameters of the aerosols were in the respirable range with the largest value being 5.17 ± 0.87 μm. CONCLUSIONS:This delivery system has been shown to consistently deliver a high respirable dose of mannitol powder. Since this setup does not require disconnection of patients from the ventilator, it is safer for hypoxemic patients and easier to be adapted in a real clinical use.
journal_name
J Aerosol Med Pulm Drug Delivjournal_title
Journal of aerosol medicine and pulmonary drug deliveryauthors
Feng B,Tang P,Leung SS,Dhanani J,Chan HKdoi
10.1089/jamp.2016.1320subject
Has Abstractpub_date
2017-04-01 00:00:00pages
100-107issue
2eissn
1941-2711issn
1941-2703journal_volume
30pub_type
杂志文章abstract:BACKGROUND:Researchers, using checklists, have identified that 30%-90% of patients make errors in inhaler use. It is not certain whether these errors affect the delivery of medication. We have developed an electronic monitor (INCA™) that records audio each time an inhaler is used, providing objective information on inh...
journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章
doi:10.1089/jamp.2016.1334
更新日期:2017-08-01 00:00:00
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章,多中心研究
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更新日期:2016-04-01 00:00:00
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章,随机对照试验
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
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doi:10.1089/jamp.2011.0902
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章
doi:10.1089/jamp.2019.1538
更新日期:2020-04-01 00:00:00
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章
doi:10.1089/jamp.2008.0700
更新日期:2008-12-01 00:00:00
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章,评审
doi:10.1089/jamp.2014.1136
更新日期:2015-02-01 00:00:00
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章,评审
doi:10.1089/jamp.2011.0876
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:The Abbreviated Impactor Measurement (AIM) concept simplifies determination of aerodynamic size metrics for inhaler quality control testing. A similar approach is needed to compare in vitro particle size distribution metrics with human respiratory tract (HRT) deposition. METHODS:An abbreviated impactor base...
journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章
doi:10.1089/jamp.2011.0925
更新日期:2012-08-01 00:00:00
abstract::Antibiotic-resistant bacterial infections have renewed interest in finding substitute methods of treatment. The purpose of the present in vitro study was to investigate the possibility of respiratory delivery of a Burkholderia cepacia complex (BCC) bacteriophage by nebulized aerosol administration. Bacteriophages in i...
journal_title:Journal of aerosol medicine and pulmonary drug delivery
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doi:10.1089/jamp.2008.0701
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章
doi:10.1089/jamp.2017.1412
更新日期:2018-08-01 00:00:00
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章
doi:10.1089/jamp.2015.1208
更新日期:2015-12-01 00:00:00
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
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doi:10.1089/jamp.2014.1191
更新日期:2015-12-01 00:00:00
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章
doi:10.1089/jamp.2009.0778
更新日期:2010-10-01 00:00:00
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章
doi:10.1089/jamp.2017.1376
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:The effectiveness of metered-dose inhalers (MDIs) in delivering medication to the lungs highly depends on its correct usage technique. Current guidelines state optimal technique for high lung deposition should include a slow inhalation (>5 seconds) at an inspiratory flow rate of 30 L/min and inhaler actuatio...
journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章
doi:10.1089/jamp.2015.1278
更新日期:2017-08-01 00:00:00
abstract:: Background: Many substances used in inhalation research are water soluble and can be administered as nebulized solutions. Typical examples are therapeutic, small-molecular agents, or macromolecules. Another category is a number of water-soluble agents used for airway diagn...
journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章
doi:10.1089/jamp.2019.1554
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:The site of deposition in the respiratory tract for aerosolized, inhaled therapeutic drugs depends on both the particles' aerodynamic size and the patient's breathing pattern. METHODS:In 21 healthy subjects with normal lung function, we evaluated an extremely slow inhalation of a large 9.5-μm MMAD particle ...
journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章
doi:10.1089/jamp.2008.0711
更新日期:2010-12-01 00:00:00
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章
doi:10.1089/jamp.2014.1174
更新日期:2015-10-01 00:00:00
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章
doi:10.1089/jamp.2017.1379
更新日期:2017-12-01 00:00:00
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journal_title:Journal of aerosol medicine and pulmonary drug delivery
pub_type: 杂志文章
doi:10.1089/jamp.2010.0868
更新日期:2011-12-01 00:00:00