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Evaluation of Aerosol Drug Delivery Options during Adult Mechanical Ventilation in the COVID-19 Era
Drug delivery devices used for aerosol therapy during mechanical ventilation to ease the symptoms of respiratory diseases provide beneficial treatment but can also pose challenges. Reflecting the significant changes in global guidance around aerosol usage and lung-protective ventilation strategies,...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8539467/ https://www.ncbi.nlm.nih.gov/pubmed/34683867 http://dx.doi.org/10.3390/pharmaceutics13101574 |
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author | Naughton, Piers J. Joyce, Mary Mac Giolla Eain, Marc O’Sullivan, Andrew MacLoughlin, Ronan |
author_facet | Naughton, Piers J. Joyce, Mary Mac Giolla Eain, Marc O’Sullivan, Andrew MacLoughlin, Ronan |
author_sort | Naughton, Piers J. |
collection | PubMed |
description | Drug delivery devices used for aerosol therapy during mechanical ventilation to ease the symptoms of respiratory diseases provide beneficial treatment but can also pose challenges. Reflecting the significant changes in global guidance around aerosol usage and lung-protective ventilation strategies, seen in response to the COVID-19 pandemic, for the first time, we describe the drug delivery performance of commonly used devices under these conditions. Here, vibrating mesh nebuliser (VMN), jet nebuliser (JN) and pressurised metered-dose inhaler (pMDI) performance was assessed during simulated adult mechanical ventilation. Both standard test breathing patterns and those representatives of low tidal volume (LTV) ventilation with concurrent active and passive humidification were investigated. Drug delivery using a VMN was significantly greater than that with a JN and pMDI for both standard and LTV ventilation. Humidification type did not affect the delivered dose across all device types for standard ventilation. Significant variability in the pMDI dosing was evident, depending on the timing of actuation and the adapter type used. pMDI actuation synchronised with inspiration resulted in a higher delivered drug dose. The type of adapter used for pMDI actuation influenced drug delivery, with the highest dose observed using the CombiHaler. |
format | Online Article Text |
id | pubmed-8539467 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-85394672021-10-24 Evaluation of Aerosol Drug Delivery Options during Adult Mechanical Ventilation in the COVID-19 Era Naughton, Piers J. Joyce, Mary Mac Giolla Eain, Marc O’Sullivan, Andrew MacLoughlin, Ronan Pharmaceutics Article Drug delivery devices used for aerosol therapy during mechanical ventilation to ease the symptoms of respiratory diseases provide beneficial treatment but can also pose challenges. Reflecting the significant changes in global guidance around aerosol usage and lung-protective ventilation strategies, seen in response to the COVID-19 pandemic, for the first time, we describe the drug delivery performance of commonly used devices under these conditions. Here, vibrating mesh nebuliser (VMN), jet nebuliser (JN) and pressurised metered-dose inhaler (pMDI) performance was assessed during simulated adult mechanical ventilation. Both standard test breathing patterns and those representatives of low tidal volume (LTV) ventilation with concurrent active and passive humidification were investigated. Drug delivery using a VMN was significantly greater than that with a JN and pMDI for both standard and LTV ventilation. Humidification type did not affect the delivered dose across all device types for standard ventilation. Significant variability in the pMDI dosing was evident, depending on the timing of actuation and the adapter type used. pMDI actuation synchronised with inspiration resulted in a higher delivered drug dose. The type of adapter used for pMDI actuation influenced drug delivery, with the highest dose observed using the CombiHaler. MDPI 2021-09-28 /pmc/articles/PMC8539467/ /pubmed/34683867 http://dx.doi.org/10.3390/pharmaceutics13101574 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Naughton, Piers J. Joyce, Mary Mac Giolla Eain, Marc O’Sullivan, Andrew MacLoughlin, Ronan Evaluation of Aerosol Drug Delivery Options during Adult Mechanical Ventilation in the COVID-19 Era |
title | Evaluation of Aerosol Drug Delivery Options during Adult Mechanical Ventilation in the COVID-19 Era |
title_full | Evaluation of Aerosol Drug Delivery Options during Adult Mechanical Ventilation in the COVID-19 Era |
title_fullStr | Evaluation of Aerosol Drug Delivery Options during Adult Mechanical Ventilation in the COVID-19 Era |
title_full_unstemmed | Evaluation of Aerosol Drug Delivery Options during Adult Mechanical Ventilation in the COVID-19 Era |
title_short | Evaluation of Aerosol Drug Delivery Options during Adult Mechanical Ventilation in the COVID-19 Era |
title_sort | evaluation of aerosol drug delivery options during adult mechanical ventilation in the covid-19 era |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8539467/ https://www.ncbi.nlm.nih.gov/pubmed/34683867 http://dx.doi.org/10.3390/pharmaceutics13101574 |
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