Michael D Davis, Jessica L Saunders, Coral Ringer, Rebecca Engberg, Yi Zhao, Robert M DiBlasi, Bruce K Rubin
{"title":"健康儿童计量吸入器训练前后气溶胶沉积的体内外相关性","authors":"Michael D Davis, Jessica L Saunders, Coral Ringer, Rebecca Engberg, Yi Zhao, Robert M DiBlasi, Bruce K Rubin","doi":"10.1088/1752-7163/acc8f1","DOIUrl":null,"url":null,"abstract":"<p><p>Although pressurized metered dose inhaler (pMDI) education is a routine part of childhood asthma management and encouraging 'optimal breathing patterns' (i.e. slowly, deeply, completely, and with a mouth seal on the mouthpiece) is an integral part of recommended pMDI education, there is currently no quantifiable way to determine if a child is inhaling their medication correctly or optimally through a valved holding chamber (VHC). The TipsHaler™ (tVHC) is a prototype VHC device that measures inspiratory time, flow, and volume without changing the properties of the medication aerosol. The measurements<i>in vivo</i>recorded by the tVHC can be downloaded and transferred to a spontaneous breathing lung model to simulate the inhalational patterns<i>in vitro</i>and also determine the deposition of inhaled aerosol mass with each pattern. We hypothesized that pediatric patients' inhalational patterns when using a pMDI would improve after active coaching via tVHC. This would increase the pulmonary deposition of inhaled aerosols in an<i>in vitro</i>model. To test this hypothesis, we conducted a single-site, prospective, pilot, pre-and-post intervention study paired with a bedside-to-bench experiment. Healthy, inhaler-naïve subjects used a placebo inhaler in conjunction with the tVHC before and after coaching and recorded inspiratory parameters. These recordings were then implemented into a spontaneous breathing lung model during albuterol MDI delivery, and pulmonary deposition of albuterol was quantified. In this pilot study, active coaching resulted in a statistically significant increase in inspiratory time (<i>n</i>= 8,<i>p</i>= 0.0344, 95%CI: 0.082 to ∞). tVHC recorded inspiratory parameters obtained from patients were successfully implemented in the<i>in vitro</i>model, which demonstrated that both inspiratory time (<i>n</i>= 8,<i>r</i>= 0.78,<i>p <</i>0.001, 95%CI: 0.47-0.92) and volume (<i>n</i>= 8,<i>r</i>= 0.58,<i>p =</i>0.0186, 95%CI: 0.15-0.85) strongly correlate with pulmonary deposition of inhaled drugs.</p>","PeriodicalId":15306,"journal":{"name":"Journal of breath research","volume":"17 3","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"<i>In vitro-in vivo</i>correlation of aerosol deposition before and after metered-dose inhaler coaching in healthy children.\",\"authors\":\"Michael D Davis, Jessica L Saunders, Coral Ringer, Rebecca Engberg, Yi Zhao, Robert M DiBlasi, Bruce K Rubin\",\"doi\":\"10.1088/1752-7163/acc8f1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Although pressurized metered dose inhaler (pMDI) education is a routine part of childhood asthma management and encouraging 'optimal breathing patterns' (i.e. slowly, deeply, completely, and with a mouth seal on the mouthpiece) is an integral part of recommended pMDI education, there is currently no quantifiable way to determine if a child is inhaling their medication correctly or optimally through a valved holding chamber (VHC). The TipsHaler™ (tVHC) is a prototype VHC device that measures inspiratory time, flow, and volume without changing the properties of the medication aerosol. The measurements<i>in vivo</i>recorded by the tVHC can be downloaded and transferred to a spontaneous breathing lung model to simulate the inhalational patterns<i>in vitro</i>and also determine the deposition of inhaled aerosol mass with each pattern. We hypothesized that pediatric patients' inhalational patterns when using a pMDI would improve after active coaching via tVHC. This would increase the pulmonary deposition of inhaled aerosols in an<i>in vitro</i>model. To test this hypothesis, we conducted a single-site, prospective, pilot, pre-and-post intervention study paired with a bedside-to-bench experiment. Healthy, inhaler-naïve subjects used a placebo inhaler in conjunction with the tVHC before and after coaching and recorded inspiratory parameters. These recordings were then implemented into a spontaneous breathing lung model during albuterol MDI delivery, and pulmonary deposition of albuterol was quantified. In this pilot study, active coaching resulted in a statistically significant increase in inspiratory time (<i>n</i>= 8,<i>p</i>= 0.0344, 95%CI: 0.082 to ∞). tVHC recorded inspiratory parameters obtained from patients were successfully implemented in the<i>in vitro</i>model, which demonstrated that both inspiratory time (<i>n</i>= 8,<i>r</i>= 0.78,<i>p <</i>0.001, 95%CI: 0.47-0.92) and volume (<i>n</i>= 8,<i>r</i>= 0.58,<i>p =</i>0.0186, 95%CI: 0.15-0.85) strongly correlate with pulmonary deposition of inhaled drugs.</p>\",\"PeriodicalId\":15306,\"journal\":{\"name\":\"Journal of breath research\",\"volume\":\"17 3\",\"pages\":\"\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2023-04-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of breath research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1088/1752-7163/acc8f1\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"BIOCHEMICAL RESEARCH METHODS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of breath research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1088/1752-7163/acc8f1","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"BIOCHEMICAL RESEARCH METHODS","Score":null,"Total":0}
In vitro-in vivocorrelation of aerosol deposition before and after metered-dose inhaler coaching in healthy children.
Although pressurized metered dose inhaler (pMDI) education is a routine part of childhood asthma management and encouraging 'optimal breathing patterns' (i.e. slowly, deeply, completely, and with a mouth seal on the mouthpiece) is an integral part of recommended pMDI education, there is currently no quantifiable way to determine if a child is inhaling their medication correctly or optimally through a valved holding chamber (VHC). The TipsHaler™ (tVHC) is a prototype VHC device that measures inspiratory time, flow, and volume without changing the properties of the medication aerosol. The measurementsin vivorecorded by the tVHC can be downloaded and transferred to a spontaneous breathing lung model to simulate the inhalational patternsin vitroand also determine the deposition of inhaled aerosol mass with each pattern. We hypothesized that pediatric patients' inhalational patterns when using a pMDI would improve after active coaching via tVHC. This would increase the pulmonary deposition of inhaled aerosols in anin vitromodel. To test this hypothesis, we conducted a single-site, prospective, pilot, pre-and-post intervention study paired with a bedside-to-bench experiment. Healthy, inhaler-naïve subjects used a placebo inhaler in conjunction with the tVHC before and after coaching and recorded inspiratory parameters. These recordings were then implemented into a spontaneous breathing lung model during albuterol MDI delivery, and pulmonary deposition of albuterol was quantified. In this pilot study, active coaching resulted in a statistically significant increase in inspiratory time (n= 8,p= 0.0344, 95%CI: 0.082 to ∞). tVHC recorded inspiratory parameters obtained from patients were successfully implemented in thein vitromodel, which demonstrated that both inspiratory time (n= 8,r= 0.78,p <0.001, 95%CI: 0.47-0.92) and volume (n= 8,r= 0.58,p =0.0186, 95%CI: 0.15-0.85) strongly correlate with pulmonary deposition of inhaled drugs.
期刊介绍：
Journal of Breath Research is dedicated to all aspects of scientific breath research. The traditional focus is on analysis of volatile compounds and aerosols in exhaled breath for the investigation of exogenous exposures, metabolism, toxicology, health status and the diagnosis of disease and breath odours. The journal also welcomes other breath-related topics.
Typical areas of interest include:
Big laboratory instrumentation: describing new state-of-the-art analytical instrumentation capable of performing high-resolution discovery and targeted breath research; exploiting complex technologies drawn from other areas of biochemistry and genetics for breath research.
Engineering solutions: developing new breath sampling technologies for condensate and aerosols, for chemical and optical sensors, for extraction and sample preparation methods, for automation and standardization, and for multiplex analyses to preserve the breath matrix and facilitating analytical throughput. Measure exhaled constituents (e.g. CO2, acetone, isoprene) as markers of human presence or mitigate such contaminants in enclosed environments.
Human and animal in vivo studies: decoding the ''breath exposome'', implementing exposure and intervention studies, performing cross-sectional and case-control research, assaying immune and inflammatory response, and testing mammalian host response to infections and exogenous exposures to develop information directly applicable to systems biology. Studying inhalation toxicology; inhaled breath as a source of internal dose; resultant blood, breath and urinary biomarkers linked to inhalation pathway.
Cellular and molecular level in vitro studies.
Clinical, pharmacological and forensic applications.
Mathematical, statistical and graphical data interpretation.
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