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婴幼儿体内沉积气溶胶剂量的测量。

Measurements of deposited aerosol dose in infants and small children.

作者信息

Corcoran Timothy E

机构信息

Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.

Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.

出版信息

Ann Transl Med. 2021 Apr;9(7):595. doi: 10.21037/atm-20-2045.

Abstract

Pediatric patients are very dependent on inhaled aerosol medications. There are significant differences in how these aerosols deposit in the lungs of children adults that may affect the efficacy of the therapies. Inefficient aerosol delivery to children, caused by factors such as high mouth and throat deposition during oral inhalation, significant losses within adjunct devices such as masks, and high rates of nasal deposition during cannula delivery, can lead to dosing that is difficult to control. Here we discuss the methods, such as deposition scintigraphy, that are used to assess inhaled dose and review previous studies where these techniques have been applied to measure dosing in children. This includes studies of nebulizers and metered dose inhalers and delivery through adjuncts such as facemasks and nasal cannulas. We discuss the factors that can lead to inefficient inhaled drug delivery and high levels of mouth and throat deposition in children. Finally, we propose areas of innovation to improve inhaled drug delivery to this population. There is a need for child-specific technologies for inhaled drug delivery. This includes the use of smart devices that can guide pediatric breathing patterns and better engage children during treatments, the use of smaller aerosols which are less likely to deposit in the upper airways after inhalation, and the design of better nasal cannula interfaces for aerosol delivery to infants.

摘要

儿科患者非常依赖吸入气雾剂药物。这些气雾剂在儿童和成人肺部的沉积方式存在显著差异,这可能会影响治疗效果。由于诸如口服吸入时在口腔和咽喉的高沉积率、在面罩等辅助装置中的大量损失以及插管给药时鼻腔的高沉积率等因素,导致向儿童输送气雾剂效率低下,进而可能导致剂量难以控制。在此,我们讨论用于评估吸入剂量的方法,如沉积闪烁扫描法,并回顾以往将这些技术应用于测量儿童给药剂量的研究。这包括对雾化器和定量吸入器的研究以及通过面罩和鼻插管等辅助装置进行的给药研究。我们讨论了可能导致儿童吸入药物输送效率低下以及口腔和咽喉高沉积水平的因素。最后,我们提出了改进向该人群吸入药物输送的创新领域。需要针对儿童的吸入药物输送技术。这包括使用能够引导儿科呼吸模式并在治疗过程中更好地吸引儿童的智能设备、使用吸入后不太可能在上呼吸道沉积的较小气雾剂,以及设计更好的用于向婴儿输送气雾剂的鼻插管接口。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cee8/8105848/a605f0f2a8ea/atm-09-07-595-f1.jpg

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