Timothy E Corcoran1,2,3, Al Saville4, Phillip S Adams5, Darragh J Johnston2, Michael R Czachowski6, Yuliya A Domnina7, Jiuann-Huey Lin7, Daniel J Weiner8, Alex S Huber2, Joan Sanchez De Toledo7, Cecilia W Lo9. 1. Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania. 2. Chemical and Petroleum Engineering Department, University of Pittsburgh, Pittsburgh, Pennsylvania. 3. Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania. 4. Respiratory Department, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. 5. Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania. 6. Nuclear Medicine Department, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. 7. Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania. 8. Pediatric Pulmonary Medicine, Allergy, and Immunology, University of Pittsburgh, Pittsburgh, Pennsylvania. 9. Department of Developmental Biology, University of Pittsburgh, Pittsburgh, Pennsylvania.
Abstract
AIM: Nasal cannulas are used to provide oxygen support for infants and have been considered as a means for delivering aerosols to the lungs. To measure mucociliary clearance in the lungs of infants with congenital heart defects, we delivered radiopharmaceutical aerosols via a nasal cannula. Here we report on the pulmonary and nasal deposition of these aerosols. METHOD: A total of 18 infants (median age = 26 days; quartiles = 11-74 days) performed clearance measurements soon before or after corrective cardiac surgery. The regional aerosol deposition was assessed using gamma camera imaging. RESULTS: Cannula flow rate significantly affected pulmonary dosing. Flow rates useful for oxygen support were associated with low pulmonary deposition (2 L/min; mean, 4.5% of deposited dose; range, 2%-9%; n = 7) and high nasal deposition. Much lower cannula flow rates increased the pulmonary deposition (0.2 L/min; mean, 33.5% of deposited dose; range, 15%-51%; n = 5; P = 0.005 vs 2 L/min). The ratio of nose/lung dosing was approximately 26:1 at 2 L/min and 2:1 at 0.2 L/min. Bench studies demonstrated cannula output rates of 10.2 ± 1.7% (2 L/min) and 3.3 ± 0.4% (0.2 L/min) of the loaded nebulizer dose during a 2-minute delivery. Combining in vitro and in vivo results, we estimate that 0.46% of the loaded nebulizer dose reaches the lungs at 2 L/min vs 1.10% at 0.2 L/min during a 2-minute delivery. CONCLUSION: With the delivery system used here, pulmonary aerosol delivery via nasal cannula was very inefficient at the flow rates required to provide oxygen support. Even at low flows, nasal deposition was substantial and local toxicity must be considered.
AIM: Nasal cannulas are used to provide oxygen support for infants and have been considered as a means for delivering aerosols to the lungs. To measure mucociliary clearance in the lungs of infants with congenital heart defects, we delivered radiopharmaceutical aerosols via a nasal cannula. Here we report on the pulmonary and nasal deposition of these aerosols. METHOD: A total of 18 infants (median age = 26 days; quartiles = 11-74 days) performed clearance measurements soon before or after corrective cardiac surgery. The regional aerosol deposition was assessed using gamma camera imaging. RESULTS: Cannula flow rate significantly affected pulmonary dosing. Flow rates useful for oxygen support were associated with low pulmonary deposition (2 L/min; mean, 4.5% of deposited dose; range, 2%-9%; n = 7) and high nasal deposition. Much lower cannula flow rates increased the pulmonary deposition (0.2 L/min; mean, 33.5% of deposited dose; range, 15%-51%; n = 5; P = 0.005 vs 2 L/min). The ratio of nose/lung dosing was approximately 26:1 at 2 L/min and 2:1 at 0.2 L/min. Bench studies demonstrated cannula output rates of 10.2 ± 1.7% (2 L/min) and 3.3 ± 0.4% (0.2 L/min) of the loaded nebulizer dose during a 2-minute delivery. Combining in vitro and in vivo results, we estimate that 0.46% of the loaded nebulizer dose reaches the lungs at 2 L/min vs 1.10% at 0.2 L/min during a 2-minute delivery. CONCLUSION: With the delivery system used here, pulmonary aerosol delivery via nasal cannula was very inefficient at the flow rates required to provide oxygen support. Even at low flows, nasal deposition was substantial and local toxicity must be considered.
Authors: Karl Bass; Mohammad A M Momin; Connor Howe; Ghali Aladwani; Sarah Strickler; Arun V Kolanjiyil; Michael Hindle; Robert M DiBlasi; Worth Longest Journal: AAPS PharmSciTech Date: 2022-04-19 Impact factor: 3.246
Authors: Connor Howe; Mohammad A M Momin; Dale R Farkas; Serena Bonasera; Michael Hindle; P Worth Longest Journal: Pharm Res Date: 2021-08-30 Impact factor: 4.580
Authors: Connor Howe; Mohammad A M Momin; Karl Bass; Ghali Aladwani; Serena Bonasera; Michael Hindle; Philip Worth Longest Journal: J Aerosol Med Pulm Drug Deliv Date: 2022-02-14 Impact factor: 3.440
Authors: Phillip S Adams; Timothy E Corcoran; Jiuann-Huey Lin; Daniel J Weiner; Joan Sanchez-de-Toledo; Cecilia W Lo Journal: Front Cardiovasc Med Date: 2021-04-23