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Pharmaceutics
Volume 15
Issue 8
10.3390/pharmaceutics15082080
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Article

The Use of an Inspiration-Synchronized Vibrating Mesh Nebulizer for Prolonged Inhalative Iloprost Administration in Mechanically Ventilated Patients—An In Vitro Model

by
Matthias Otto
1,
Yannik Kropp
1,
Evelyn Jäger
2,
Michael Neumaier
2,
Manfred Thiel
1,
Michael Quintel
3,4 and
Charalambos Tsagogiorgas
1,5,*
1
Department of Anaesthesiology and Critical Care Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68165 Mannheim, Germany
2
Institute for Clinical Chemistry, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany
3
Department of Anaesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
4
Department of Anaesthesiology, DONAUISAR Klinikum Deggendorf, Perlasberger Str. 41, 94469 Deggendorf, Germany
5
Department of Anaesthesiology and Critical Care Medicine, St. Elisabethen Hospital Frankfurt, Ginnheimer Straße 3, 60487 Frankfurt am Main, Germany
*
Author to whom correspondence should be addressed.
Pharmaceutics 2023, 15(8), 2080; https://doi.org/10.3390/pharmaceutics15082080
Submission received: 7 July 2023 / Revised: 27 July 2023 / Accepted: 1 August 2023 / Published: 3 August 2023
(This article belongs to the Special Issue Drug Delivery Systems for Respiratory Diseases)
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Abstract

Mechanically ventilated patients suffering from acute respiratory distress syndrome (ARDS) frequently receive aerosolized iloprost. Because of prostacyclin’s short half-life, prolonged inhalative administration might improve its clinical efficacy. But, this is technically challenging. A solution might be the use of inspiration-synchronized vibrating mesh nebulizers (VMNsyn), which achieve high drug deposition rates while showing prolonged nebulization times. However, there are no data comparing prolonged to bolus iloprost nebulization using a continuous vibrating mesh nebulizer (VMNcont) and investigating the effects of different ventilation modes on inspiration-synchronized nebulization. Therefore, in an in vitro model of mechanically ventilated adults, a VMNsyn and a VMNcont were compared in volume-controlled (VC-CMV) and pressure-controlled continuous mandatory ventilation (PC-CMV) regarding iloprost deposition rate and nebulization time. During VC-CMV, the deposition rate of the VMNsyn was comparable to the rate obtained with the VMNcont, but 10.9% lower during PC-CMV. The aerosol output of the VMNsyn during both ventilation modes was significantly lower compared to the VMNcont, leading to a 7.5 times longer nebulization time during VC-CMV and only to a 4.2 times longer nebulization time during PC-CMV. Inspiration-synchronized nebulization during VC-CMV mode therefore seems to be the most suitable for prolonged inhalative iloprost administration in mechanically ventilated patients.
Keywords: nebulizers; aerosol drug therapy; iloprost; vibrating mesh nebulizer; aerosol deposition; mechanical ventilation; in vitro nebulizers; aerosol drug therapy; iloprost; vibrating mesh nebulizer; aerosol deposition; mechanical ventilation; in vitro

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MDPI and ACS Style

Otto, M.; Kropp, Y.; Jäger, E.; Neumaier, M.; Thiel, M.; Quintel, M.; Tsagogiorgas, C. The Use of an Inspiration-Synchronized Vibrating Mesh Nebulizer for Prolonged Inhalative Iloprost Administration in Mechanically Ventilated Patients—An In Vitro Model. Pharmaceutics 2023, 15, 2080. https://doi.org/10.3390/pharmaceutics15082080

AMA Style

Otto M, Kropp Y, Jäger E, Neumaier M, Thiel M, Quintel M, Tsagogiorgas C. The Use of an Inspiration-Synchronized Vibrating Mesh Nebulizer for Prolonged Inhalative Iloprost Administration in Mechanically Ventilated Patients—An In Vitro Model. Pharmaceutics. 2023; 15(8):2080. https://doi.org/10.3390/pharmaceutics15082080

Chicago/Turabian Style

Otto, Matthias, Yannik Kropp, Evelyn Jäger, Michael Neumaier, Manfred Thiel, Michael Quintel, and Charalambos Tsagogiorgas. 2023. "The Use of an Inspiration-Synchronized Vibrating Mesh Nebulizer for Prolonged Inhalative Iloprost Administration in Mechanically Ventilated Patients—An In Vitro Model" Pharmaceutics 15, no. 8: 2080. https://doi.org/10.3390/pharmaceutics15082080

APA Style

Otto, M., Kropp, Y., Jäger, E., Neumaier, M., Thiel, M., Quintel, M., & Tsagogiorgas, C. (2023). The Use of an Inspiration-Synchronized Vibrating Mesh Nebulizer for Prolonged Inhalative Iloprost Administration in Mechanically Ventilated Patients—An In Vitro Model. Pharmaceutics, 15(8), 2080. https://doi.org/10.3390/pharmaceutics15082080

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