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Extended Pharmacopeial Characterization of Surfactant Aerosols Generated by a Customized eFlow Neos Nebulizer Delivered through Neonatal Nasal Prongs

The delivery of nebulized medications to preterm infants during Non-Invasive Ventilation (NIV) remains an unmet clinical need. In this regard, the effective delivery of nebulized surfactant has been particularly investigated in preclinical and clinical studies. In this work, we investigated the feas...

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Autores principales: Bianco, Federico, Pasini, Elena, Nutini, Marcello, Murgia, Xabier, Stoeckl, Carolin, Schlun, Martin, Hetzer, Uwe, Bonelli, Sauro, Lombardini, Marta, Milesi, Ilaria, Pertile, Marisa, Minocchieri, Stephan, Salomone, Fabrizio, Bucholski, Albert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238214/
https://www.ncbi.nlm.nih.gov/pubmed/32252349
http://dx.doi.org/10.3390/pharmaceutics12040319
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author Bianco, Federico
Pasini, Elena
Nutini, Marcello
Murgia, Xabier
Stoeckl, Carolin
Schlun, Martin
Hetzer, Uwe
Bonelli, Sauro
Lombardini, Marta
Milesi, Ilaria
Pertile, Marisa
Minocchieri, Stephan
Salomone, Fabrizio
Bucholski, Albert
author_facet Bianco, Federico
Pasini, Elena
Nutini, Marcello
Murgia, Xabier
Stoeckl, Carolin
Schlun, Martin
Hetzer, Uwe
Bonelli, Sauro
Lombardini, Marta
Milesi, Ilaria
Pertile, Marisa
Minocchieri, Stephan
Salomone, Fabrizio
Bucholski, Albert
author_sort Bianco, Federico
collection PubMed
description The delivery of nebulized medications to preterm infants during Non-Invasive Ventilation (NIV) remains an unmet clinical need. In this regard, the effective delivery of nebulized surfactant has been particularly investigated in preclinical and clinical studies. In this work, we investigated the feasibility of delivering nebulized surfactant through various commercially available nasal prong types. We first performed a compendial characterization of surfactant aerosols generated by the eFlow Neos nebulizer, customized to be used in neonates, determining the amount of surfactant delivered by the device as well as the aerodynamic characteristics of surfactant aerosols. Additionally, we extended the compendial characterization by testing the effect of different nasal prong types on the estimated lung dose using a realistic Continuous Positive Airway Pressure (CPAP) circuit that included a cast of the upper airways of a preterm neonate. The compendial characterization of surfactant aerosols delivered through different nasal prongs achieved relatively high delivered surfactant doses (in the range 63–74% of the nominal dose), with aerodynamic characteristics displaying mass median aerodynamic diameters ranging between 2.52 and 2.81 µm. Nevertheless, when using a representative in vitro setup mimicking NIV in a clinical setting, significant differences were observed in terms of the estimated lung dose accounting for up to two-fold differences (from 10% to 20% estimated lung deposition of the nominal dose) depending on the chosen nasal prong type. Considering that surfactant lung deposition rates are correlated with therapeutic efficacy, this study points out the relevance of choosing the appropriate NIV interface to maximize the lung dose of nebulized medications.
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spelling pubmed-72382142020-05-28 Extended Pharmacopeial Characterization of Surfactant Aerosols Generated by a Customized eFlow Neos Nebulizer Delivered through Neonatal Nasal Prongs Bianco, Federico Pasini, Elena Nutini, Marcello Murgia, Xabier Stoeckl, Carolin Schlun, Martin Hetzer, Uwe Bonelli, Sauro Lombardini, Marta Milesi, Ilaria Pertile, Marisa Minocchieri, Stephan Salomone, Fabrizio Bucholski, Albert Pharmaceutics Article The delivery of nebulized medications to preterm infants during Non-Invasive Ventilation (NIV) remains an unmet clinical need. In this regard, the effective delivery of nebulized surfactant has been particularly investigated in preclinical and clinical studies. In this work, we investigated the feasibility of delivering nebulized surfactant through various commercially available nasal prong types. We first performed a compendial characterization of surfactant aerosols generated by the eFlow Neos nebulizer, customized to be used in neonates, determining the amount of surfactant delivered by the device as well as the aerodynamic characteristics of surfactant aerosols. Additionally, we extended the compendial characterization by testing the effect of different nasal prong types on the estimated lung dose using a realistic Continuous Positive Airway Pressure (CPAP) circuit that included a cast of the upper airways of a preterm neonate. The compendial characterization of surfactant aerosols delivered through different nasal prongs achieved relatively high delivered surfactant doses (in the range 63–74% of the nominal dose), with aerodynamic characteristics displaying mass median aerodynamic diameters ranging between 2.52 and 2.81 µm. Nevertheless, when using a representative in vitro setup mimicking NIV in a clinical setting, significant differences were observed in terms of the estimated lung dose accounting for up to two-fold differences (from 10% to 20% estimated lung deposition of the nominal dose) depending on the chosen nasal prong type. Considering that surfactant lung deposition rates are correlated with therapeutic efficacy, this study points out the relevance of choosing the appropriate NIV interface to maximize the lung dose of nebulized medications. MDPI 2020-04-02 /pmc/articles/PMC7238214/ /pubmed/32252349 http://dx.doi.org/10.3390/pharmaceutics12040319 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bianco, Federico
Pasini, Elena
Nutini, Marcello
Murgia, Xabier
Stoeckl, Carolin
Schlun, Martin
Hetzer, Uwe
Bonelli, Sauro
Lombardini, Marta
Milesi, Ilaria
Pertile, Marisa
Minocchieri, Stephan
Salomone, Fabrizio
Bucholski, Albert
Extended Pharmacopeial Characterization of Surfactant Aerosols Generated by a Customized eFlow Neos Nebulizer Delivered through Neonatal Nasal Prongs
title Extended Pharmacopeial Characterization of Surfactant Aerosols Generated by a Customized eFlow Neos Nebulizer Delivered through Neonatal Nasal Prongs
title_full Extended Pharmacopeial Characterization of Surfactant Aerosols Generated by a Customized eFlow Neos Nebulizer Delivered through Neonatal Nasal Prongs
title_fullStr Extended Pharmacopeial Characterization of Surfactant Aerosols Generated by a Customized eFlow Neos Nebulizer Delivered through Neonatal Nasal Prongs
title_full_unstemmed Extended Pharmacopeial Characterization of Surfactant Aerosols Generated by a Customized eFlow Neos Nebulizer Delivered through Neonatal Nasal Prongs
title_short Extended Pharmacopeial Characterization of Surfactant Aerosols Generated by a Customized eFlow Neos Nebulizer Delivered through Neonatal Nasal Prongs
title_sort extended pharmacopeial characterization of surfactant aerosols generated by a customized eflow neos nebulizer delivered through neonatal nasal prongs
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238214/
https://www.ncbi.nlm.nih.gov/pubmed/32252349
http://dx.doi.org/10.3390/pharmaceutics12040319
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