Targeted Lung Deposition From Nebulization Is Not Improved in the Lateral Decubitus Position in Healthy Volunteers.
BACKGROUND: Clinical benefits of inhaled therapies are related to the amount of drug deposited in the targeted area of the lung. Body positions that influence the distribution of lung ventilation should impact lung deposition of the nebulized drug. The aim of this study was to analyze the immediate...
| Publicado en: | Respiratory Care Vol. 64; no. 12; pp. 1537 - 1545 |
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| Autores principales: | , , , , , , , |
| Formato: | diagnostic images research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Dec2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=140207788&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 140207788 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Dec2019 vid: 64 iid: 12 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 140207788 140207788 140207788 10.4187/respcare.06978 140207788 ppf: 1537 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Targeted Lung Deposition From Nebulization Is Not Improved in the Lateral Decubitus Position in Healthy Volunteers. aug: au: Reychler, Gregory San Miguel-Pagola, Marta Aubriot, Anne-Sophie Herrero-Cortina, Beatriz Lecocq, Vinciane Hesse, Michel Liistro, Giuseppe Jamar, Fran¸ois affil: Institut de Recherche Expérimentale et Clinique (IREC), Groupe de Recher che en Kinésitherapie Respiratoire, Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium sug: subj: Lateral Position Administration, Inhalation Nebulizers and Vaporizers Lung Drug Effects Human Randomized Controlled Trials Male Organic Chemicals Drug Delivery Systems Sitting Tomography Tomography, Emission-Computed, Single-Photon Adult Confidence Intervals Single-Blind Studies Body Positions Data Analysis Software T-Tests Random Assignment Adult: 19-44 years Male ab: BACKGROUND: Clinical benefits of inhaled therapies are related to the amount of drug deposited in the targeted area of the lung. Body positions that influence the distribution of lung ventilation should impact lung deposition of the nebulized drug. The aim of this study was to analyze the immediate effect of body position while the subject lies on his side (lateral decubitus) during nebulization on 3-dimen- sional total and regional lung deposition. METHODS: A randomized crossover trial was performed on healthy male volunteers without cardiovascular or pulmonary disease. A technetium-99m diethylene- triaminepentaacetic acid (99mTc-DTPA) solution (4 mL) was nebulized using an individual-controlled inhalation system in left lateral decubitus and sitting positions with a 96-h washout period (43 inspira- tions of 4 s [ie, drug delivered until second 3] with a tidal volume of 0.8 L and a low inspiratory flow (200 mL/s). Drug deposition was followed with the use of planar images and single-photon-emission computed tomography combined with low-resolution computed tomography. Total and regional depo- sitions were the main outcomes. Penetration index was also considered. RESULTS: Six participants (26.8 ± 6.9 y old) were included. Total lung deposition tended to be higher in a sitting position than in a lateral decubitus position: 10.2 ± 0.9% of nominal dose (95% CI 9.1-11.3) vs 8.6 ± 1.4% of nominal dose (95% CI 6.8-10.4) (P = .09). The deposition was significantly reduced in the dependent (left) lung in the lateral decubitus position: 3.5 ± 0.7% of nominal dose (95% CI 2.6-4.3) vs 4.7 ± 0.3% of nominal dose (95% CI 4.3-5.0) (P = .03). Penetration index was only influenced by body position for the dependent (left) lung (P = .043). CONCLUSIONS: The total amount of drug delivered to the lungs during nebulization with an individual-controlled inhalation system tended to decrease when performed in the left lateral decubitus position. Moreover, contrary to the initial hypothesis, the deposition of particles in the dependent lung was not improved by the lateral decubitus position in this configuration. (ClinicalTrials.gov registration NCT02451501.) pubtype: Academic Journal doctype: diagnostic images research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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