Assessment of Aerosol Drug Delivery to Simulated Adult and Paediatric Patients with Varying Lung Diseases during Mechanical Ventilation
Shane Raftery1, Marc Mac Giolla Eain1, Mary Joyce1, Andrew O’Sullivan1 & Ronan MacLoughlin1
1Aerogen Ltd., Galway Business Park, Dangan, Galway, H91HE941, Ireland
Mechanical ventilation, used in combination with nebulised therapeutics, plays an integral role in the management of patients with acute respiratory disease. Disease type and severity alters pulmonary function and therefore could potentially affect aerosol drug delivery. This study investigated different disease states and the potential effect of each on aerosol drug delivery during mechanical ventilation. Aerosol drug delivery using a vibrating mesh nebuliser was assessed in two different patient cohorts, adult and paediatric, with four different diseased lung states, and compared to a normal healthy lung profile, during simulated mechanical ventilation. Diseased lung breath patterns were provided by a breathing simulator. The mass of drug captured on a filter was determined using UV spectroscopy at 276nm. For both adult and paediatric simulated patients, there was a statistically significant difference in aerosol dose (%) delivered across all disease states assessed (p<0.05) with the largest dose delivered to the normal healthy lung (23.85 ± 1.16% for adults and 7.70 ± 0.36% for paediatrics). In comparing disease states, a significant difference was reported for the simulated adult disease states assessed (13.79 ±0 .73% for COPD; 8.82 ± 0.47% for ARDS) but not for paediatrics (5.91 ± 0.48% for asthma; 5.35 ± 0.29% for obstructive lung disease). It can be concluded that aerosol drug delivery can be affected by the condition of the patient and the severity of the disease.
During mechanical ventilation, aerosol delivery is significantly affected by disease state in adults and paediatrics. This effect may be mediated by both lung compliance and resistance. These findings may aid in optimising aerosol-medicated therapeutic interventions in the ventilated patient.