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 solution mig...
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| Main Authors: | , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
3 August 2023
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| In: |
Pharmaceutics
Year: 2023, Volume: 15, Issue: 8, Pages: 1-13 |
| ISSN: | 1999-4923 |
| DOI: | 10.3390/pharmaceutics15082080 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.3390/pharmaceutics15082080 Verlag, kostenfrei, Volltext: https://www.mdpi.com/1999-4923/15/8/2080 
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| Author Notes: | Matthias Otto, Yannik Kropp, Evelyn Jäger, Michael Neumaier, Manfred Thiel, Michael Quintel and Charalambos Tsagogiorgas |
| 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 (VMNsyn), 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 (VMNcont) and investigating the effects of different ventilation modes on inspiration-synchronized nebulization. Therefore, in an in vitro model of mechanically ventilated adults, a VMNsyn and a VMNcont 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 VMNsyn was comparable to the rate obtained with the VMNcont, but 10.9% lower during PC-CMV. The aerosol output of the VMNsyn during both ventilation modes was significantly lower compared to the VMNcont, 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: | Gesehen am 19.12.2023 |
| Physical Description: | Online Resource |
| ISSN: | 1999-4923 |
| DOI: | 10.3390/pharmaceutics15082080 |