Journal of aerosol medicine and pulmonary drug delivery
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J Aerosol Med Pulm Drug Deliv · Oct 2011
An in vitro assessment of aerosol delivery through patient breathing circuits used with medical air or a helium-oxygen mixture.
The bench experiments presented herein were conducted in order to investigate the influence of carrier gas, either medical air or a helium-oxygen mixture (78% He, 22% O2), on the droplet size distribution and aerosol mass delivered from a vibrating mesh nebulizer through a patient breathing circuit. ⋯ Ventilation with helium-oxygen in place of air-oxygen mixtures can influence both the droplet size distribution and mass of nebulized aerosol delivered through patient breathing circuits. Assessment of these effects on aerosol delivery is important when incorporating helium-oxygen into patient ventilation strategies.
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J Aerosol Med Pulm Drug Deliv · Aug 2011
Pharmacokinetics and tolerability of BAY41-6551 in subjects with chronic kidney disease.
Abstract Background: BAY41-6551, a drug-device combination in development for adjunctive treatment of Gram-negative pneumonia in mechanically ventilated patients, consists of amikacin formulated for inhalation coupled with the Pulmonary Drug Delivery System (PDDS) Clinical aerosol delivery platform. This study evaluated safety, tolerability, and pharmacokinetics (PK) of BAY41-6551 in subjects with chronic kidney disease (CKD). ⋯ Single doses of BAY41-6551 were well tolerated in subjects with CKD. HD effectively removed amikacin from serum in subjects with ESRD, and the timing relative to BAY41-6551 administration was an important determinant of systemic amikacin exposure. Nevertheless, standard precautionary measures for intravenous amikacin should apply for patients receiving BAY41-6551, and dose adjustments and/or dialysis should be considered for subjects with severe renal impairment.
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J Aerosol Med Pulm Drug Deliv · Aug 2011
Clinical TrialPharmacokinetics and tolerability of amikacin administered as BAY41-6551 aerosol in mechanically ventilated patients with gram-negative pneumonia and acute renal failure.
BAY41-6551, a drug-device combination in development for adjunctive treatment of Gram-negative pneumonia in intubated and mechanically ventilated patients, consists of amikacin formulated for inhalation coupled with the Pulmonary Drug Delivery System (PDDS) Clinical aerosol delivery platform. Given the predominantly renal clearance of aminoglycosides, understanding systemic amikacin exposure and safety during administration of BAY41-6551 to patients with acute renal failure (ARF) is clinically important. ⋯ CVVHDF appears to provide adequate clearance of systemically absorbed amikacin in mechanically ventilated patients with ARF, suggesting that dose adjustments for BAY41-6551 are probably not necessary for this patient population. Nonetheless, the standard precautionary measures for critically ill patients receiving i.v. amikacin should be followed for patients with ARF who are treated with BAY41-6551.
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J Aerosol Med Pulm Drug Deliv · Apr 2011
Improving the lung delivery of nasally administered aerosols during noninvasive ventilation-an application of enhanced condensational growth (ECG).
Aerosol drug delivery during noninvasive ventilation (NIV) is known to be inefficient due to high depositional losses. To improve drug delivery efficiency, the concept of enhanced condensational growth (ECG) was recently proposed in which a submicrometer or nanoaerosol reduces extrathoracic deposition and subsequent droplet size increase promotes lung retention. The objective of this study was to provide proof-of-concept that the ECG approach could improve lung delivery of nasally administered aerosols under conditions consistent with NIV. ⋯ Application of the ECG approach may significantly improve the delivery of pharmaceutical aerosols during NIV and may open the door for using the nasal route to routinely deliver pulmonary medications.
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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.