Optimal Connection for Tiotropium SMI Delivery through Mechanical Ventilation: An In Vitro Study

We aimed to quantify Soft Mist Inhalers (SMI) delivery to spontaneous breathing model and compare with different adapters via endotracheal tube during mechanical ventilation or by manual resuscitation. A tiotropium SMI was used with a commercial in-line adapter and a T-adapter placed between the Y-a...

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Veröffentlicht in:Pharmaceutics 2020-03, Vol.12 (3), p.291
Hauptverfasser: Fang, Tien-Pei, Chen, Yu-Ju, Yang, Tsung-Ming, Wang, Szu-Hu, Hung, Ming-Szu, Chiu, Shu-Hua, Li, Hsin-Hsien, Fink, James B, Lin, Hui-Ling
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Sprache:eng
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Zusammenfassung:We aimed to quantify Soft Mist Inhalers (SMI) delivery to spontaneous breathing model and compare with different adapters via endotracheal tube during mechanical ventilation or by manual resuscitation. A tiotropium SMI was used with a commercial in-line adapter and a T-adapter placed between the Y-adapter and the inspiratory limb of the ventilator circuit during mechanical ventilation. The SMI was actuated at the beginning of inspiration and expiration. In separate experiments, a manual resuscitator with T-adapter was attached to endotracheal tube, collecting filter, and a passive test lung. Drug was eluted from collecting filters with salt-based solvent and analyzed using high-performance liquid chromatography. Results showed the percent of SMI label dose inhaled was 3-fold higher with the commercial in-line adapter with actuation during expiration than when synchronized with inspiration. SMI with T-adapter delivery via ventilator was similar to inhalation (1.20%) or exhalation (1.02%), and both had lower delivery dose than with manual resuscitator (2.80%; = 0.01). The inhaled dose via endotracheal tube was much lower than inhaled dose with spontaneous breathing (22.08%). In conclusion, the inhaled dose with the commercial adapter was higher with SMI actuated during expiration, but still far less than reported spontaneous inhaled dose.
ISSN:1999-4923
1999-4923
DOI:10.3390/pharmaceutics12030291