Development challenges and opportunities in aerosol drug delivery systems in non-invasive ventilation in adults

Reychler, Gregory (Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Bruxelles, Belgium; Service de Pneumologie, Cliniques universitaires Saint-Luc, Bruxelles, Belgium) ; Michotte, Jean-Bernard (Service de Pneumologie, Cliniques universitaires Saint-Luc, Bruxelles, Belgium; HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland)

Introduction: With the gain in popularity of non-invasive ventilation (NIV), particularly in patients requiring drug delivery by aerosol therapy, the feasibility of the combination between NIV and aerosol therapy has regularly been questioned. Areas covered: This review covers the in vitro and in vivo studies which explored the effects of this combination on pulmonary drug delivery (imaging and pharmacological studies) and on physiological measurements. Expert opinion: Even if the feasibility of the combination is evident, the type of nebulizer influences the lung deposition with a greater delivery with vibrating mesh nebulizers. The influence of the interfaces of NIV devices should be further investigated even if vented masks may seem less efficient for nebulization. There is also a need to develop new devices and modalities, or specific components better designed for a more efficient delivery, to offer more optimal particles size to lung delivery. The use of spacer also seems promising to improve the lung delivery even if strong evidences are still missing. Finally, it would be interesting to explore the influence of all spontaneous modes which use different flow-time curves. Further investigations should focus on the synchronization of the delivery with the inspiratory part of the respiratory cycle in patients during NIV, particularly when delivering toxic or expensive drugs.


Keywords:
Article Type:
scientifique
Faculty:
Santé
Branch:
Physiothérapie
School:
HESAV
Institute:
Aucun institut
Subject(s):
Santé
Date:
2019-02
Pagination:
11 p.
Published in:
Expert opinion on drug delivery
Numeration (vol. no.):
2019, vol. 16, no. 2, pp. 153-162
DOI:
ISSN:
1742-5247
Appears in Collection:

Note: The status of this file is: restricted


 Record created 2019-07-08, last modified 2019-10-11

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