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首页> 外文期刊>Journal of aerosol medicine and pulmonary drug delivery >Factors Determining In Vitro Lung Deposition of Albuterol Aerosol Delivered by Ventolin Metered-Dose Inhaler
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Factors Determining In Vitro Lung Deposition of Albuterol Aerosol Delivered by Ventolin Metered-Dose Inhaler

机译：测定ventolin计量吸入器递送的阿巴丁醇气溶胶体外肺部沉积的因素

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Background: The effectiveness of metered-dose inhalers (MDIs) in delivering medication to the lungs highly depends on its correct usage technique. Current guidelines state optimal technique for high lung deposition should include a slow inhalation (>5 seconds) at an inspiratory flow rate of 30L/min and inhaler actuation at the start of inhalation. However, these recommendations were based on clinical studies using CFC (chlorofluorocarbon)-MDIs and in vitro studies of HFA (hydrofluoroalkane)-MDIs using idealized MDI techniques of uniform inhalation and actuation, disregarding the nonuniform techniques of actual patients. Methods: To better understand the effects of time-varying MDI usage parameters on lung deposition of aerosol delivered by an HFA-MDI, we conducted an in vitro study modeled on real-life variable inspiratory flow and actuation techniques recorded from 15 subjects with asthma/chronic obstructive pulmonary disease (COPD). We developed a model representing the time-varying inspiratory flow waveforms and actuation timings based on 43 MDI techniques recorded from patients. Furthermore, we constructed an in vitro experimental setup using a mouth-throat cast, programmable MDI actuator, and breath simulator to evaluate lung deposition for the MDI techniques derived from our model. Results: High inspiratory flow rates, 60-90L/min, consistently resulted in high in vitro lung deposition (>40%) of aerosol (albuterol delivered from Ventolin HFA-MDI) compared to 30L/min when MDI actuation occurred in the first half of inhalation. Also, positive coordination resulted in higher in vitro lung deposition compared with negative or zero coordination (actuating before or at the start of inspiration). Furthermore, variation in coordination affected lung deposition more significantly (23%) than flow rate or duration of inspiration (5%). Conclusions: In an in vitro experimental model based on inhalation data from patients with asthma and COPD, we demonstrated that aerosol lung deposition emitted from Ventolin HFA-MDI is most optimal for MDI actuation in the first half of inspiration at high flow rates (60-90L/min).
机译：背景：计量剂量吸入器（MDIS）在向肺部递送药物的有效性高度取决于其正确的使用技术。目前的指导原则，高肺沉积的最佳技术应包括30L / min的吸气流速的缓慢吸入（> 5秒），并且在吸入开始时吸入致动。然而，这些建议是基于使用CFC（氯氟烃）-MDIS和HFA（氢氟烷烃）-MDIS的体外研究的临床研究，使用理想的MDI技术均匀吸入和致动，忽略了实际患者的非均匀技术。方法：为了更好地了解时变MDI使用参数对HFA-MDI递送的气溶胶沉积的影响，我们进行了一种在现实寿命的可变吸气流动和致动技术上进行了模拟的体外研究，从15个受试者记录过哮喘/慢性阻塞性肺病（COPD）。我们开发了一种模型，其代表了基于患者记录的43 MDI技术的时变吸气流波形和致动时间。此外，我们使用口喉铸造，可编程MDI执行器和呼气模拟器构建了一种体外实验设置，以评估源自我们模型的MDI技术的肺部沉积。结果：高吸气流速，60-90L / min，始终如一导致高分体肺沉积（> 40％）气溶胶（从ventolin HFA-MDI递送的羟丙醇），而当MDI致动发生在上半场时，相比于30L / min吸入。此外，与负或零协调相比，阳性配位导致较高的体外肺沉积（在启动之前或在启动时启动）。此外，协调的变异影响肺沉积比流动速率或吸气的持续时间（23％）（5％）。结论：在来自哮喘和COPD患者的吸入数据的体外实验模型中，我们证明了从ventolin HFA-MDI发出的气溶胶肺部沉积在高流量速率下，对MDI致动的MDI致动最佳（60- 90L / min）。

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