Lung deposition and systemic bioavailability of different aerosol devices with and without humidification in mechanically ventilated patients.

Background During mechanical ventilation medical aerosol delivery has been reported to be upto two fold greater with dry inhaled gas than with heated humidity. Urine levels at 0.5 h post dose (URSAL0.5%) has been confirmed as an index of lung deposition and 24 h (URSAL24%) as index of systemic absor...

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Publicado en:Heart & Lung Vol. 46; no. 6; pp. 464 - 468
Autores principales: Moustafa, Islam O.F., Ali, Mohammed R. A.-A., Al Hallag, Moataz, Rabea, Hoda, Fink, James B., Dailey, Patricia, Abdelrahim, Mohamed E.A.
Formato: research Journal Article
Publicado: Elsevier B.V. Nov2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2017
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      pub: Elsevier B.V.
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        125779962
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        10.1016/j.hrtlng.2017.08.004
        125779962
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        atl: Lung deposition and systemic bioavailability of different aerosol devices with and without humidification in mechanically ventilated patients.
      aug:
        au:
          Moustafa, Islam O.F.
          Ali, Mohammed R. A.-A.
          Al Hallag, Moataz
          Rabea, Hoda
          Fink, James B.
          Dailey, Patricia
          Abdelrahim, Mohamed E.A.
        affil: Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
      sug:
        subj:
          Aerosols
          Nebulizers and Vaporizers
          Respiration, Artificial
          Biological Availability
          Drug Delivery Systems
          Human
          Crossover Design
          Male
          Female
          Albuterol Urine
          Male
          Female
      ab: Background During mechanical ventilation medical aerosol delivery has been reported to be upto two fold greater with dry inhaled gas than with heated humidity. Urine levels at 0.5 h post dose (URSAL0.5%) has been confirmed as an index of lung deposition and 24 h (URSAL24%) as index of systemic absorption. Our aim was to determine the effect of humidification and aerosol device type on drug delivery to ventilated patients using urine levels. Methods In a randomized crossover design, 36 (18female) mechanically ventilated patients were assigned to one of three groups. Groups 1 and 2 received 5000 μg salbutamol using vibrating mesh (VM) and jet nebulizers (JN), respectively, while group 3 received 1600 μg (16 puffs) of salbutamol via metered dose inhaler with AeroChamber Vent (MDI-AV). All devices were placed in the inspiratory limb of ventilator downstream from the humidifier. Each subject received aerosol with and without humidity at >24 h intervals with >12 h washout periods between salbutamol doses. Patients voided urine 15 min before each study dose and urine samples were collected at 0.5 h post dosing and pooled for the next 24 h. Results The MDI-AV and VM resulted in a higher percentage of urinary salbutamol levels compared to the JN (p < 0.05). Urine levels were similar between humidity and dry conditions. Conclusions Our findings suggest that in-vitro reports overestimate the impact of dry vs. heated humidified conditions on the delivery of aerosol during invasive mechanical ventilation.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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