000002416 001__ 2416
000002416 005__ 20190326164007.0
000002416 022__ $$a1941-2711
000002416 0247_ $$2DOI$$a10.1089/jamp.2016.1339
000002416 037__ $$aARTICLE
000002416 041__ $$aeng
000002416 245__ $$aPulmonary drug delivery following continuous vibrating mesh nebulization and inspiratory synchronized vibrating mesh nebulization during noninvasive ventilation in healthy volunteers
000002416 260__ $$c2018-02
000002416 269__ $$a2018-02
000002416 300__ $$a9 p.
000002416 506__ $$avisible
000002416 520__ $$aBackground: A breath-synchronized nebulization option that could potentially improve drug delivery during noninvasive positive pressure ventilation (NIPPV) is currently not available on single-limb circuit bilevel ventilators. The aim of this study was to compare urinary excretion of amikacin following aerosol delivery with a vibrating mesh nebulizer coupled to a single-limb circuit bilevel ventilator, using conventional continuous (Conti-Neb) and experimental inspiratory synchronized (Inspi-Neb) nebulization modes. Materials and Methods: A crossover clinical trial involving 6 noninvasive ventilated healthy volunteers (mean age of 32.3– 9.5 y) randomly assigned to both vibrating mesh nebulization modes was conducted: Inspi-Neb delivered aerosol during only the whole inspiratory phase, whereas Conti-Neb delivered aerosol continuously. All subjects inhaled amikacin solution (500 mg/4 mL) during NIPPV using a single-limb bilevel ventilator (inspiratory positive airway pressure: 12 cm H2O, and expiratory positive airway pressure: 5 cm H2O). Pulmonary drug delivery of amikacin following both nebulization modes was compared by urinary excretion of drug for 24 hours post-inhalation. Results: The total daily amount of amikacin excreted in the urine was significantly higher with Inspi-Neb (median: 44.72 mg; interquartile range [IQR]: 40.50–65.13) than with Conti-Neb (median: 40.07 mg; IQR: 31.00–43.73), ( p ¼ 0.02). The elimination rate constant of amikacin (indirect measure of the depth of drug penetration into the lungs) was significantly higher with Inspi-Neb (median: 0.137; IQR: 0.113–0.146) than with Conti-Neb (median: 0.116; IQR: 0.105–0.130), ( p ¼ 0.02). However, the mean pulmonary drug delivery rate, expressed as the ratio between total daily urinary amount of amikacin and nebulization time, was significantly higher with Conti-Neb (2.03 mg/min) than with Inspi-Neb (1.09 mg/min) ( p < 0.01). Conclusions: During NIPPV with a single-limb circuit bilevel ventilator, the use of inspiratory synchronized vibrating mesh nebulization may improve pulmonary drug delivery compared with conventional continuous vibrating mesh nebulization.$$9eng
000002416 546__ $$aEnglish
000002416 540__ $$acorrect
000002416 592__ $$aHEIG-VD
000002416 592__ $$aHESAV
000002416 592__ $$biAi-Institut d'Automatisation Industrielle
000002416 592__ $$cIngénierie et Architecture
000002416 592__ $$cSanté
000002416 592__ $$dPhysiothérapie
000002416 655__ $$ascientifique
000002416 65017 $$aIngénierie
000002416 65017 $$aSanté
000002416 6531_ $$aaerosol delivery$$9eng
000002416 6531_ $$aamikacin$$9eng
000002416 6531_ $$abilevel ventilator$$9eng
000002416 6531_ $$abreath-synchronized nebulizer$$9eng
000002416 6531_ $$ahealthy volunteers,$$9eng
000002416 6531_ $$anebulization$$9eng
000002416 6531_ $$anebulization mode$$9eng
000002416 6531_ $$anoninvasive positive pressure ventilation$$9eng
000002416 6531_ $$apulmonary drug delivery$$9eng
000002416 6531_ $$asingle-limb$$9eng
000002416 6531_ $$acircuit ventilator$$9eng
000002416 6531_ $$avibrating mesh nebulizer$$9eng
000002416 700__ $$uHESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland$$aMichotte, Jean-Bernard
000002416 700__ $$uSchool of Management and Engineering Vaud, HES-SO // University of Applied Sciences Western Switzerland$$aStaderini, Enrico
000002416 700__ $$uCliniques Universitaires Saint-Luc, Centre de Référence pour la Mucoviscidose, 1200 Brussels, Belgium$$aAubriot, Anne-Sophie
000002416 700__ $$uLigue pulmonaire neuchâteloise, 2034 Peseux, Switzerland$$aJossen, Emilie
000002416 700__ $$uCliniques Universitaires Saint-Luc, Service des soins intensifs, 1200 Brussels, Belgium$$aDugernier, Jonathan
000002416 700__ $$uCliniques Universitaires Saint-Luc, Service de Pneumologie; Université Catholique de Louvain, Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, 1200 Brussels, Belgium$$aLiistro, Giuseppe
000002416 700__ $$uCliniques Universitaires Saint-Luc, Service de Pneumologie; Université Catholique de Louvain, Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, 1200 Brussels, Belgium$$aReychler, Gregory
000002416 773__ $$g2018, 31, 1, pp. 33-41$$tJournal of Aerosol Medicine and Pulmonary Drug Delivery
000002416 8564_ $$uhttps://hesso.tind.io/record/2416/files/Staderini_2018_Pulmonary_drug_delivery.pdf$$s191837
000002416 906__ $$aGREEN
000002416 909CO $$pGLOBAL_SET$$ooai:hesso.tind.io:2416
000002416 950__ $$aI2 San2
000002416 980__ $$ascientifique
000002416 981__ $$ascientifique