通过 I-neb 自适应雾化输送（AAD）系统进行的呼吸模式——潮汐式或缓慢而深沉——会影响（99m）Tc-DTPA 在肺部的沉积。
Mode of breathing-tidal or slow and deep-through the I-neb Adaptive Aerosol Delivery (AAD) system affects lung deposition of (99m)Tc-DTPA.
机构信息
Philips Respironics, Parsippany, New Jersey 01970, USA.
出版信息
J Aerosol Med Pulm Drug Deliv. 2010 Apr;23 Suppl 1(Suppl 1):S37-43. doi: 10.1089/jamp.2009.0786.
BACKGROUND
The I-neb AAD System was designed to deliver aerosol with two different breathing pattern algorithms: the Tidal Breathing Mode (TBM) and the Target Inhalation Mode (TIM). For the purpose of the study, the TBM breathing pattern algorithm was set to guide the subjects to inhalation during tidal breathing with aerosol pulsed during 50-80% of the time spent on inhalation, whereas the TIM breathing pattern was set to guide the subject to a slow and deep inhalation of up to approximately 9 sec with aerosol pulsed for up to 7 sec, leaving 2 sec for particle deposition in the lungs. In TIM, the inspiratory flow was guided to approximately 20 L/min through a built-in resistance in the mouthpiece.
METHODS
We have, in a randomized, open-label, crossover study of 12 healthy subjects evaluated lung deposition following administration of a radiolabeled aerosol from the I-neb AAD System with the TBM and TIM breathing patterns.
RESULTS
The results showed that mean lung deposition was significantly higher when using the I-neb AAD System with the TIM breathing pattern (73.3%) than with the TBM breathing pattern (62.8%). The mean exhaled fractions were low (<1%) for both breathing patterns. The nebulization time was significantly shorter with the TIM breathing pattern (3.0 min) than with the TBM breathing pattern (4.7 min).
CONCLUSIONS
The results of the present study showed that lung deposition with the slow and deep inhalation achieved through the I-neb AAD System in TIM was superior to the lung deposition achieved during tidal breathing in TBM. With the combination of high lung deposition, almost no loss of aerosol during exhalation, and short nebulization time the I-neb AAD System with the TIM breathing pattern should be of special value to patients who require multiple daily dosing of aerosolized medication, are using drugs that should not be wasted into the room air, or would benefit from a more efficient delivery system.
背景
I-neb AAD 系统旨在通过两种不同的呼吸模式算法输送气雾剂：潮汐呼吸模式（TBM）和目标吸入模式（TIM）。在研究目的中，TBM 呼吸模式算法被设置为引导受试者在潮式呼吸时吸入气雾剂，在吸入时间的 50-80%期间脉冲气雾剂，而 TIM 呼吸模式算法被设置为引导受试者进行缓慢而深沉的吸入，吸气时间最长可达约 9 秒，同时气雾剂脉冲时间最长可达 7 秒，在肺部中留下 2 秒用于颗粒沉积。在 TIM 中，通过吸嘴中的内置阻力将吸气流量引导至约 20 L/min。
方法
我们在一项随机、开放标签、交叉研究中，评估了 12 名健康受试者在使用 I-neb AAD 系统时，TBM 和 TIM 呼吸模式下给予放射性标记气雾剂后的肺部沉积情况。
结果
结果表明，使用 TIM 呼吸模式时，I-neb AAD 系统的平均肺部沉积率明显更高（73.3%），而 TBM 呼吸模式时的平均肺部沉积率较低（62.8%）。两种呼吸模式下的呼气分数均较低（<1%）。TIM 呼吸模式的雾化时间（3.0 分钟）明显短于 TBM 呼吸模式（4.7 分钟）。
结论
本研究结果表明，I-neb AAD 系统在 TIM 中通过缓慢而深沉的吸入实现的肺部沉积优于 TBM 中在潮式呼吸时实现的肺部沉积。I-neb AAD 系统结合了高肺部沉积率、几乎没有气雾剂在呼气中损失，以及较短的雾化时间，对于需要每日多次给予气雾剂药物的患者、使用不应浪费到室内空气中的药物的患者，或从更有效的输送系统中受益的患者，具有特殊价值。
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