In vitro assessment of drug delivery through an endotracheal tube using a dry powder inhaler delivery system
In vitro assessment of drug delivery through an endotracheal tube using a dry powder inhaler delivery system
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DOI：
10.1136/thx.51.1.75
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发表时间：
1996-01-01
期刊：
影响因子：
10
通讯作者：
LeSouef, PN
中科院分区：
文献类型：
--
作者：
Everard, ML;Devadason, SG;LeSouef, PN
背景-喷射雾化器和计量吸入器被广泛用于将雾化药物输送到成人重症监护病房插管患者的肺部。使用这些系统的药物输送已被证明是低效的，并且两种输送方式都有可能在反应性呼吸道疾病患者中诱发反常的支气管收缩。方法通过实验来确定是否可以通过气管内管从干粉输送系统输送药物。200亩的布地奈德涡轮增压机被封闭在一个房间里，这样它就可以插入呼吸机电路。实验用多级液体撞击器进行，其中药物以60 L/分钟的速度通过涡轮增压器和气管内管被吸入，提供了通过该路线可实现的最大药物输送的指标。进行了第二系列实验，其中涡轮增压机被放置在使用Servo 900C容量循环呼吸器的呼吸机回路中。在吸气阶段从涡轮吸气器输送的药物被放置在9 mm气管插管末端和模型肺之间的过滤器上收集。潮气量为500ml，吸气时间为0.5s。结果：30%的标称剂量通过气管导管，并被收集在多级液体撞击器中。结论：这项体外研究表明，来自干粉吸入器(本例中为Turbohaler)的药物可以通过气管内管满意地输送，这项技术的临床评价现已公布。
Background - Jet nubulisers and metered dose inhalers are widely used to deliver aerosolised drugs to the lungs of intubated patients in adult intensive care units. Drug delivery using these systems has been shown to be inefficient and both forms of delivery have the potential to induce paradoxical bronchoconstriction in patients with reactive airways disease.Methods - Experiments were carried out to determine whether it was possible to deliver drug from a dry powder delivery system through an endotracheal tube. A 200 mu g budesonide Turbohaler was enclosed in a chamber which allowed it to be inserted into a ventilator circuit. Experiments were performed with a multistage liquid impinger in which drug was drawn through the Turbohaler and endotracheal tube at 60 l/min providing an index of the maximum drug delivery achievable via this route. A second series of experiments was performed in which the Turbohaler was placed in a ventilator circuit using a Servo 900C volume cycled ventilator. Drug delivered from the Turbohaler during the inspiratory phase was collected on a filter placed between the end of a 9 mm endotracheal tube and a model lung. A tidal volume of 500 ml and inspiratory time of 0.5 seconds was used. Budesonide was assayed using an ultraviolet spectrophotometric assay.Results - Thirty percent of the nominal dose passed through the endotracheal tube and was collected in the multistage liquid impinger. Mean drug delivery to the filter in the ventilator circuit was 20%.Conclusions - This in vitro study indicates that drugs from dry powder inhalers (in this case the Turbohaler) can be satisfactorily delivered through endotracheal tubes and that clinical evaluation of this technique is now indicated.