Calculated Deposition in Growing Tracheobronchial Airways: Effect of Growth-Rate Assumptions

In vitro exposure to complete engine emissions - a mini-review

Outdoor air pollution is classified as carcinogenic to humans and exposure to it contributes to increased incidence of various diseases, including cardiovascular, neurological or pulmonary disorders. Vehicle engine emissions represent a significant part of outdoor air pollutants, particularly in large cities with high population density. Considering the potentially negative health impacts of engine emissions exposure, the application of reliable test systems allowing assessment of the biological effects of these pollutants is crucial. The exposure systems should use relevant, preferably multicellular, cell models that are treated with the complete engine exhaust (i.e. a realistic mixture of particles, chemical compounds bound to them and gaseous phase) at the air-liquid interface. The controlled delivery and characterization of chemical and/or particle composition of the exhaust should be possible. In this mini-review we report on such exposure systems that have been developed to date. We focus on a brief description and technical characterization of the systems, and discuss the biological parameters detected following exposure to a gasoline/diesel exhaust. Finally, we summarize and compare findings from the individual systems, including their advantages/limitations.

Albuterol delivery via metered dose inhaler in a spontaneously breathing pediatric tracheostomy model

RATIONALE

Little data are available regarding efficiency of drug delivery devices and techniques despite their widespread use in spontaneously breathing tracheostomized patients. We compared patient dose achieved with different devices, inhalation techniques, tracheostomy tube sizes and breathing patterns using a spontaneously breathing tracheostomized pediatric model.

METHODS

A tracheostomy model was connected in series to a breathing simulator with a filter interposed (patient dose). Breathing patterns of a 16-month-old and a 6- and 12-year-old child with tracheostomy with internal diameters (mm) of 3.5, 4.5, and 5.5 were used. Albuterol HFAp MDI was used. Aerotrach Plus, MediBag, Aerochamber MV, Aerochamber Mini, and inline adapter with 6-inch tubing were tested. The latter 3 devices were also tested with assisted technique. Albuterol was analyzed via spectrophotometry.

RESULTS

Aerotrach Plus outperformed almost all devices tested. Aerochamber MV with unassisted technique was the second best and the adapter was the worst. Comparison of efficiency between best and worst performer ranged from 3- to 17.2-fold. The 16-month-old breathing pattern and the 3.5 mm tracheostomy tube had the lowest patient dose. The use of assisted technique decreased patient dose by 18-67% for the 4.5 and 5.5 mm but not for 3.5 mm tracheostomy tubes. A median of 7.4% of the nominal dose was deposited in the tracheostomy tubes.

CONCLUSIONS

Aerotrach Plus and the adapter were the most and least efficient devices respectively. Tracheostomy size and breathing pattern affected drug delivery. The use of assisted technique reduced aerosol delivery.