Journal of aerosol medicine and pulmonary drug delivery
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J Aerosol Med Pulm Drug Deliv · Dec 2010
Characterization of exhaled particles from the healthy human lung--a systematic analysis in relation to pulmonary function variables.
Noninvasive monitoring of airway inflammation is important for diagnosis and treatment intervention of lung disease. Mediators of interest are often nonvolatile molecules that are exhaled as aerosols and captured by breath condensation. Because analysis of exhaled breath condensate has been troublesome in the past, partly due to poor standardization and unknown dilution, we investigated in detail the influence of respiratory variables on exhaled particle number and size distribution during tidal breathing in healthy volunteers. ⋯ We conclude that online determination of exhaled aerosols from the human lungs is a prerequisite to standardize the assessment of nonvolatile mediators by normalization to the aerosol emission rate.
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J Aerosol Med Pulm Drug Deliv · Dec 2010
Randomized Controlled Trial Comparative StudyDelivery efficacy of a vibrating mesh nebulizer and a jet nebulizer under different configurations.
Jet nebulizers coupled to spacers are frequently used to promote drug lung deposition, but their clinical efficacy has not been established. Few in vivo studies have been performed with mesh nebulizers, commonly used to nebulize antibiotics. Our study compared inhaled mass and urinary drug concentration of amikacin by using three different nebulizer delivery configuration systems: a standard unvented jet nebulizer (Sidestream(®)) used alone or coupled to a 110-mL corrugated piece of tubing and a vibrating mesh nebulizer (e-Flow rapid(®)). ⋯ The total daily amount of amikacin urinary excretion (Cu) was almost twice as high with eFlow rapid(®) compared to Sidestream(®) used alone; intermediate values being observed when the device was coupled to a corrugated piece of tubing. The latter configuration was also associated with a higher total daily amount of amikacin urinary excretion. In vivo drug output rate was around threefold higher with the eFlow Rapid(®) than with the Sidestream(®) used in any configuration. These results were concordant to those obtained with in vitro analysis comparing inhaled mass of amikacin for the three nebulizers. The elimination constant (Ke) and the mass median aerodynamic diameter (MMAD) did not differ between the three devices. In conclusion, the vibrating mesh nebulizer is more efficient, promoting larger urinary drug concentration and drug output. Coupling a corrugated piece of tubing to the standard jet nebulizer favors delivery efficacy.