Abstract
BackgroundAerosol delivery through a nasal high flow (NHF) system is attractive for clinicians as it allows for simultaneous administration of oxygen and inhalable drugs. However, delivering a fine particle fraction (FPF, particle wt. fraction < 5.0 μm) of drugs into the lungs has been very challenging, with highest value of only 8%. Here, we aim to develop an efficient nose-to-lung delivery system capable of delivering improved quantities (FPF > 16%) of dry powder aerosols to the lungs via an NHF system.MethodsWe evaluated the FPF of spray-dried mannitol with leucine with a next generation impactor connected to a nasopharyngeal outlet of an adult nasal airway replica. In addition, we investigated the influence of different dispersion (20–30 L/min) and inspiratory (20–40 L/min) flow rates, on FPF.ResultsWe found an FPF of 32% with dispersion flow rate at 25 L/min and inspiratory flow rate at 40 L/min. The lowest FPF (21%) obtained was at the dispersion flow rate at 30 L/min and inspiratory flow rate at 30 L/min. A higher inspiratory flow rate was generally associated with a higher FPF. The nasal cannula accounted for most loss of aerosols.ConclusionsIn conclusion, delivering a third of inhalable powder to the lungs is possible in vitro through an NHF system using a low dispersion airflow and a highly dispersible powder. Our results may lay the foundation for clinical evaluation of powder aerosol delivery to the lungs during NHF therapy in humans.
Highlights
Aerosol delivery through a nasal high flow (NHF) system is attractive for clinicians as it allows for simultaneous administration of oxygen and inhalable drugs
We aimed to develop an efficient nose-to-lung delivery system using a dry powder inhalers (DPI) device coupled to a NHF system that can overcome the current clinical and technical limitations, with improved delivery (FPF > 15%) of powder aerosols to the lungs
At dispersion flow rates (DFR) of 20, 25 and 30 L/min, 53.5 ± 10.7, 91.2 ± 3.41 and 94.9 ± 0.34% of the loaded dose was emitted after 4 s, respectively
Summary
Aerosol delivery through a nasal high flow (NHF) system is attractive for clinicians as it allows for simultaneous administration of oxygen and inhalable drugs. We aim to develop an efficient nose-to-lung delivery system capable of delivering improved quantities (FPF > 16%) of dry powder aerosols to the lungs via an NHF system. Long-term oxygen therapy can improve survival in patients with chronic obstructive pulmonary disease (COPD) and chronic respiratory failure [1, 2]. Nasal high-flow (NHF) therapy is a form of respiratory support used in the hospital or emergency unit [3], mainly for management of acute hypoxaemic respiratory failure [4]. NHF therapy delivers oxygen (often warm and humidified) to patients at flow rates higher than that used in traditional oxygen therapy.
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