The Use of an Inspiration-Synchronized Vibrating Mesh Nebulizer for Prolonged Inhalative Iloprost Administration in Mechanically Ventilated Patients-An In Vitro Model
Mechanically ventilated patients suffering from acute respiratory distress syndrome (ARDS) frequently receive aerosolized iloprost. Because of prostacyclin's short half-life, prolonged inhalative administration might improve its clinical efficacy. But, this is technically challenging. A solutio...
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| Main Authors: | , , , , , , |
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| Format: | Book |
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MDPI AG,
2023-08-01T00:00:00Z.
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| Online Access: | Connect to this object online. |
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| Summary: | Mechanically ventilated patients suffering from acute respiratory distress syndrome (ARDS) frequently receive aerosolized iloprost. Because of prostacyclin's short half-life, prolonged inhalative administration might improve its clinical efficacy. But, this is technically challenging. A solution might be the use of inspiration-synchronized vibrating mesh nebulizers (VMN<sub>syn</sub>), which achieve high drug deposition rates while showing prolonged nebulization times. However, there are no data comparing prolonged to bolus iloprost nebulization using a continuous vibrating mesh nebulizer (VMN<sub>cont</sub>) and investigating the effects of different ventilation modes on inspiration-synchronized nebulization. Therefore, in an in vitro model of mechanically ventilated adults, a VMN<sub>syn</sub> and a VMN<sub>cont</sub> were compared in volume-controlled (VC-CMV) and pressure-controlled continuous mandatory ventilation (PC-CMV) regarding iloprost deposition rate and nebulization time. During VC-CMV, the deposition rate of the VMN<sub>syn</sub> was comparable to the rate obtained with the VMN<sub>cont</sub>, but 10.9% lower during PC-CMV. The aerosol output of the VMN<sub>syn</sub> during both ventilation modes was significantly lower compared to the VMN<sub>cont</sub>, leading to a 7.5 times longer nebulization time during VC-CMV and only to a 4.2 times longer nebulization time during PC-CMV. Inspiration-synchronized nebulization during VC-CMV mode therefore seems to be the most suitable for prolonged inhalative iloprost administration in mechanically ventilated patients. |
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| Item Description: | 10.3390/pharmaceutics15082080 1999-4923 |