tetano
Editor, Senior Moderator
J Aerosol Med Pulm Drug Deliv. 2015 May 14. [Epub ahead of print]
[h=1]A Proof-of-Principle Setup for Delivery of Relenza? (Zanamivir) Inhalation Powder to Intubated Patients.[/h] Leung SS[SUP]1[/SUP], Parumasivam T, Tang P, Chan HK.
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] A fatal incident was reported when a mechanical ventilated patient received nebulization of a reconstituted Relenza[SUP]?[/SUP] formulation. We propose a delivery system to introduce Relenza and other inhalation dry powders to intubated patients to avoid accidental fatalities in the future.
[h=4]METHODS:[/h] This is a bench study demonstrating the feasibility of a delivery system to introduce dry powder of Relenza to intubated patients. A dry powder inhaler placed within a delivery chamber was actuated by compressing a ventilation bag to disperse powder into a tracheal tube. The performance of two inhalers, a Diskhaler[SUP]?[/SUP] and an Osmohaler[SUP]?[/SUP], were compared. The effects of the length and size of the tracheal tube on the powder output and sizing of emitted powder were investigated using the more efficient Osmohaler[SUP]?[/SUP].
[h=4]RESULTS:[/h] The efficiency of Osmohaler in delivering Relenza to the distal end [delivered dose=30.2?0.2% and fine particle fraction (FPF)=14.5?1.7%] was significantly higher than the Diskhaler (delivered dose=18.1?4.7% and FPF=3.4?2.1%). While no differences in the delivered dose and FPF were observed between the tracheostomy and endotracheal tubes of the same internal diameter, a larger endotracheal tube (9.0 mm internal diameter) gave a 6% higher FPF compared with the smaller counterpart (7.0 mm internal diameter).
[h=4]CONCLUSION:[/h] The dry powder delivery system has been demonstrated to be capable of delivering Relenza formulation to the distal end of tracheal tubes with a reasonable delivered dose and FPF. It would be necessary for further investigation into incorporating the proposed powder delivery system within a mechanical ventilator, as well as animal and clinical studies to prove its applicability to deliver zanamivir dry powder to ventilated influenza patients in the intensive care setting.
[h=4]KEYWORDS:[/h] dry powder inhaler; endotracheal tube; influenza virus A (H1N1); tracheostomy tube; ventilated patients
PMID: 25974393 [PubMed - as supplied by publisher]
[h=1]A Proof-of-Principle Setup for Delivery of Relenza? (Zanamivir) Inhalation Powder to Intubated Patients.[/h] Leung SS[SUP]1[/SUP], Parumasivam T, Tang P, Chan HK.
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] A fatal incident was reported when a mechanical ventilated patient received nebulization of a reconstituted Relenza[SUP]?[/SUP] formulation. We propose a delivery system to introduce Relenza and other inhalation dry powders to intubated patients to avoid accidental fatalities in the future.
[h=4]METHODS:[/h] This is a bench study demonstrating the feasibility of a delivery system to introduce dry powder of Relenza to intubated patients. A dry powder inhaler placed within a delivery chamber was actuated by compressing a ventilation bag to disperse powder into a tracheal tube. The performance of two inhalers, a Diskhaler[SUP]?[/SUP] and an Osmohaler[SUP]?[/SUP], were compared. The effects of the length and size of the tracheal tube on the powder output and sizing of emitted powder were investigated using the more efficient Osmohaler[SUP]?[/SUP].
[h=4]RESULTS:[/h] The efficiency of Osmohaler in delivering Relenza to the distal end [delivered dose=30.2?0.2% and fine particle fraction (FPF)=14.5?1.7%] was significantly higher than the Diskhaler (delivered dose=18.1?4.7% and FPF=3.4?2.1%). While no differences in the delivered dose and FPF were observed between the tracheostomy and endotracheal tubes of the same internal diameter, a larger endotracheal tube (9.0 mm internal diameter) gave a 6% higher FPF compared with the smaller counterpart (7.0 mm internal diameter).
[h=4]CONCLUSION:[/h] The dry powder delivery system has been demonstrated to be capable of delivering Relenza formulation to the distal end of tracheal tubes with a reasonable delivered dose and FPF. It would be necessary for further investigation into incorporating the proposed powder delivery system within a mechanical ventilator, as well as animal and clinical studies to prove its applicability to deliver zanamivir dry powder to ventilated influenza patients in the intensive care setting.
[h=4]KEYWORDS:[/h] dry powder inhaler; endotracheal tube; influenza virus A (H1N1); tracheostomy tube; ventilated patients
PMID: 25974393 [PubMed - as supplied by publisher]