A Pediatric Upper Airway Library to Evaluate Interpatient Variability of In Silico Aerosol Deposition.
A Pediatric Upper Airway Library to Evaluate Interpatient Variability of In Silico Aerosol Deposition.
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DOI：
10.1208/s12249-023-02619-3
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发表时间：
2023-07-31
影响因子：
3.3
通讯作者：
中科院分区：
文献类型：
--
作者：
儿童患者的气道在发育过程中会发生变化，这对开发儿童特异性气雾剂治疗提出了挑战。我们的工作旨在量化的几何变化和气溶胶沉积模式在上气道的发展，在3.5个月至6岁之间的受试者使用的24个儿科模型和4个成人模型库。计算流体-颗粒动力学进行了不同的颗粒尺寸（0.1-10 μm）和流速（10-120 Lpm），经过严格分析以比较解剖学指标（会厌角（），声门与环状软骨环比值（GC比）和小儿与成人气管比（H比）），吸入器指标（颗粒直径和流速）和临床指标（年龄、性别、身高和体重）。多元非线性回归表明，所有指标都显着影响所得的沉积，个别参数的影响不同。此外，采用了主成分分析，表明GC比和性别占受试者特异性沉积之间变异性的90%。值得注意的是，年龄在儿科受试者中不具有统计学显著性，但在比较成人受试者时具有影响力。吸入器设计指标具有巨大的影响力，因此支持了对儿科特定吸入方法的迫切需求。这项工作不仅提高了处方可吸入疗法和告知儿科气雾剂优化的准确性，而且还为未来的气雾剂研究提供了一个框架，以继续努力实现优化和个性化的儿科药物。
The airway of pediatric patients’ changes through development, presenting a challenge in developing pediatric-specific aerosol therapeutics. Our work aims to quantify geometric variations and aerosol deposition patterns during upper airway development in subjects between 3.5 months - 6 years old using a library of 24 pediatric models and 4 adult models. Computational fluid-particle dynamics was performed with varying particle size (0.1–10 μm) and flow rate (10–120 Lpm), which was rigorously analyzed to compare anatomical metrics (epiglottis angle (), glottis to cricoid ring ratio (GC-ratio), and pediatric to adult trachea ratio (H-ratio)), inhaler metrics (particle diameter, , and flow rate, ), and clinical metrics (age, sex, height and weight) against aerosol deposition. Multivariate non-linear regression indicated that all metrics were all significantly influential on resultant deposition, with varying influence of individual parameters. Additionally, Principal Component Analysis was employed, indicating that , GC-ratio, , and sex accounted for 90% of variability between subject-specific deposition. Notably, age was not statistically significant amongst pediatric subjects but was influential in comparing adult subjects. Inhaler design metrics were hugely influential, thus supporting the critical need for pediatric-specific inhalable approaches. This work not only improves accuracy in prescribing inhalable therapeutics and informing pediatric aerosol optimization, but also provides a framework for future aerosol studies to continue to strive toward optimized and personalized pediatric medicine.
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影响因子：
2
作者：
Gasparrini, A.;Armstrong, B.;Kenward, M. G.
通讯作者：
Kenward, M. G.
影响因子：
3.3
作者：
BRANCATISANO, T;COLLETT, PW;ENGEL, LA
通讯作者：
ENGEL, LA
影响因子：
4.6
作者：
Bentsen, Mariann H L;Eriksen, Morten;Halvorsen, Thomas
通讯作者：
Halvorsen, Thomas
影响因子：
4.5
作者：
Feng, Yu;Zhao, Jianan;Lin, Jiang
通讯作者：
Lin, Jiang
DOI：
10.1080/15459624.2012.762608
发表时间：
2013-04-01
影响因子：
2
作者：
Cheng, Yung Sung;Su, Wei-Chung
通讯作者：
Su, Wei-Chung