Deposition studies of aerosol delivery by nasal cannula to infants
Deposition studies of aerosol delivery by nasal cannula to infants
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DOI：
10.1002/ppul.24326
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发表时间：
2019-08-01
影响因子：
3.1
通讯作者：
Lo, Cecilia W.
中科院分区：
文献类型：
--
作者：
Corcoran, Timothy E.;Saville, Al;Lo, Cecilia W.
目的鼻插管用于为婴儿提供氧气支持，并被认为是将气溶胶输送到肺部的一种手段。为了测量患有先天性心脏病的婴儿的肺中的粘膜纤毛清除率，我们通过鼻插管递送放射性药物气雾剂。在这里，我们报告了这些气溶胶的肺部和鼻腔沉积。方法共18名婴儿（中位年龄= 26天;四分位数= 11-74天）进行清除率测量之前或之后不久的心脏手术。区域气溶胶沉积进行了评估，使用伽马相机成像。结果插管流速显著影响肺剂量。用于氧气支持的流速与低肺沉积（2 L/min;平均值，沉积剂量的4.5%;范围，2%-9%; n = 7）和高鼻沉积相关。更低的插管流速增加了肺沉积（0.2 L/min;平均值，沉积剂量的33.5%;范围，15%-51%; n = 5; P = 0.005 vs 2 L/min）。2 L/min时鼻/肺给药比约为26：1，0.2 L/min时为2：1。实验室研究表明，在2分钟输注期间，插管输出率分别为装载雾化器剂量的10.2 +/- 1.7%（2 L/min）和3.3 +/- 0.4%（0.2 L/min）。结合体外和体内结果，我们估计在2分钟递送期间，0.46%的负载雾化器剂量以2 L/min到达肺部，而以0.2 L/min到达肺部的剂量为1.10%。结论使用本给药系统时，经鼻插管肺内给药的气雾剂在提供氧气支持所需的流速下效率很低。即使在低流量下，鼻腔沉积也很大，必须考虑局部毒性。
Aim Nasal cannulas are used to provide oxygen support for infants and have been considered as a means for delivering aerosols to the lungs. To measure mucociliary clearance in the lungs of infants with congenital heart defects, we delivered radiopharmaceutical aerosols via a nasal cannula. Here we report on the pulmonary and nasal deposition of these aerosols. Method A total of 18 infants (median age = 26 days; quartiles = 11-74 days) performed clearance measurements soon before or after corrective cardiac surgery. The regional aerosol deposition was assessed using gamma camera imaging. Results Cannula flow rate significantly affected pulmonary dosing. Flow rates useful for oxygen support were associated with low pulmonary deposition (2 L/min; mean, 4.5% of deposited dose; range, 2%-9%; n = 7) and high nasal deposition. Much lower cannula flow rates increased the pulmonary deposition (0.2 L/min; mean, 33.5% of deposited dose; range, 15%-51%; n = 5; P = 0.005 vs 2 L/min). The ratio of nose/lung dosing was approximately 26:1 at 2 L/min and 2:1 at 0.2 L/min. Bench studies demonstrated cannula output rates of 10.2 +/- 1.7% (2 L/min) and 3.3 +/- 0.4% (0.2 L/min) of the loaded nebulizer dose during a 2-minute delivery. Combining in vitro and in vivo results, we estimate that 0.46% of the loaded nebulizer dose reaches the lungs at 2 L/min vs 1.10% at 0.2 L/min during a 2-minute delivery. Conclusion With the delivery system used here, pulmonary aerosol delivery via nasal cannula was very inefficient at the flow rates required to provide oxygen support. Even at low flows, nasal deposition was substantial and local toxicity must be considered.