Robert Sturm1. 1. Brunnleitenweg 41, A-5061 Elsbethen, Salzburg, Austria.
Abstract
INTRODUCTION: Based upon theoretical models particle deposition and clearance in human respiratory systems affected by chronic bronchitis can be approximated reliably. As a consequence of those hypothetical results, optimal frame conditions (e.g., inhalation time and volume, particle properties) for inhalation therapies can be determined. METHODS: Simulation of particle deposition was conducted by modelling a partly or fully obstructed tracheobronchial architecture. Bronchitis-induced reductions of the airway calibres were computed by application of specific scaling factors. Three different scenarios of chronic bronchitis were modelled. Brownian motion, inertial impaction, interception, and gravitational settling were assumed as main deposition forces influencing inhaled particular mass. Tracheobronchial clearance was approximated by application of generation-specific mucus velocities as well as the consideration of a slow bronchial clearance phase, whose half-time varied between 5 and 20 days. RESULTS: Under different breathing conditions (i.e., sitting and light-work breathing) deposition of submicron and µm-sized particles is significantly enhanced within the bronchial lung region, but also alveolar deposition becomes partly enhanced. By changing the inhalation conditions target sites of therapeutic aerosols may be reached with rather high accuracy. Based on the data of this modified models, particle retention in lung airways of patients suffering from chronic bronchitis may be noticeably prolonged, with 24-hour retention values being increased by up to 50%. DISCUSSION AND CONCLUSIONS: As exhibited by the results, particle deposition behaviour in lungs affected by chronic bronchitis differs remarkably from that in healthy lungs. These theoretical finds are mostly supported by experimental data. Further, experimental and theoretical deposition results may be used for an estimation of the grade of disease. Tracheobronchial clearance reduces its efficiency with each progress of the disease which increases the probability of bacterial infections in the airways.
INTRODUCTION: Based upon theoretical models particle deposition and clearance in human respiratory systems affected by chronic bronchitis can be approximated reliably. As a consequence of those hypothetical results, optimal frame conditions (e.g., inhalation time and volume, particle properties) for inhalation therapies can be determined. METHODS: Simulation of particle deposition was conducted by modelling a partly or fully obstructed tracheobronchial architecture. Bronchitis-induced reductions of the airway calibres were computed by application of specific scaling factors. Three different scenarios of chronic bronchitis were modelled. Brownian motion, inertial impaction, interception, and gravitational settling were assumed as main deposition forces influencing inhaled particular mass. Tracheobronchial clearance was approximated by application of generation-specific mucus velocities as well as the consideration of a slow bronchial clearance phase, whose half-time varied between 5 and 20 days. RESULTS: Under different breathing conditions (i.e., sitting and light-work breathing) deposition of submicron and µm-sized particles is significantly enhanced within the bronchial lung region, but also alveolar deposition becomes partly enhanced. By changing the inhalation conditions target sites of therapeutic aerosols may be reached with rather high accuracy. Based on the data of this modified models, particle retention in lung airways of patients suffering from chronic bronchitis may be noticeably prolonged, with 24-hour retention values being increased by up to 50%. DISCUSSION AND CONCLUSIONS: As exhibited by the results, particle deposition behaviour in lungs affected by chronic bronchitis differs remarkably from that in healthy lungs. These theoretical finds are mostly supported by experimental data. Further, experimental and theoretical deposition results may be used for an estimation of the grade of disease. Tracheobronchial clearance reduces its efficiency with each progress of the disease which increases the probability of bacterial infections in the airways.
Authors: S V Culpitt; W Maziak; S Loukidis; J A Nightingale; J L Matthews; P J Barnes Journal: Am J Respir Crit Care Med Date: 1999-11 Impact factor: 21.405