Lower Inspiratory Breathing Depth Enhances Pulmonary Delivery Efficiency of ProAir Sprays

Pulmonary Oxygen Exchange in a Rhythmically Expanding–Contracting Alveolus–Capillary Model

Pulmonary gas exchanges are vital to human health, and disruptions to this process have been associated with many respiratory diseases. Previous gas exchange studies have predominately relied on whole-body testing and theoretical analysis with 1D or static models. However, pulmonary gas exchanges are inherently a dynamic process in 3D spaces with instantaneous interactions between air, blood, and tissue. This study aimed to develop a computational model for oxygen exchange that considered all factors mentioned above. Therefore, an integrated alveolus–membrane–capillary geometry was developed with prescribed rhythmic expansion/contraction. Airflow ventilation, blood perfusion, and oxygen diffusion were simulated using COMSOL. The temporal and spatial distribution of blood flow and oxygen within the capillaries were simulated under varying breathing depths and cardiac outputs. The results showed highly nonuniform blood flow distributions in the capillary network, while the rhythmic oscillation further increased this nonuniformity, leading to stagnant blood flow in the distal vessels. A static alveolus–capillary geometry underestimated perfusion by 11% for normal respirations, and the deviation grew with breathing depth. The rhythmic motion caused a phase lag in the blood flow. The blood PO2 reached equilibrium with the alveolar air after traveling 1/5–1/3 of the capillary network. The time to reach this equilibrium was significantly influenced by the air–blood barrier diffusivity, while it was only slightly affected by the perfusion rate. The computational platform in this study could be instrumental in obtaining refined knowledge of pulmonary O2 exchanges.

Two-way coupling and Kolmogorov scales on inhaler spray plume evolutions from Ventolin, ProAir, and Qvar

Previous numerical studies of pulmonary drug delivery using metered-dose inhalers (MDIs) often neglected the momentum transfer from droplets to fluid. However, Kolmogorov length scales in MDI flows can be comparable to the droplet sizes in the orifice vicinity, and their interactions can modify the spray behaviors. This study aimed to evaluate the two-way coupling effects on spray plume evolutions compared to one-way coupling. The influences from the mass loading, droplet size, and inhaler type were also examined. Large-eddy simulation and Lagrangian approach were used to simulate the flow and droplet motions. Two-way coupled predictions appeared to provide significantly improved predictions of the aerosol behaviors close to the Ventolin orifice than one-way coupling. Increasing the applied MDI dose mass altered both the fluid and aerosol dynamics, notably bending the spray plume downward when applying a dose ten times larger. The droplet size played a key role in spray dynamics, with the plume being suppressed for 2-µm aerosols and enhanced for 20-µm aerosols. The Kolmogorov length scale ratio dp/η correlated well with the observed difference in spray plumes, with suppressed plumes when dp/η < 0.1 and enhanced plumes when dp/η > 0.1. For the three inhalers considered (Ventolin, ProAir, and Qvar), significant differences were predicted using two-way and one-way coupling despite the level and manifestation of these differences varied. Two-way coupling effects were significant for MDI sprays and should be considered in future numerical studies.

Count- and mass-based dosimetry of MDI spray droplets with polydisperse and monodisperse size distributions

Most previous numerical studies of inhalation drug delivery used monodisperse aerosols or quantified deposition as the ratio of deposited particle number over the total number of released particles (i.e., count-based). These practices are reasonable when the aerosols have a sufficiently narrow size range. However, spray droplets from metered-dose inhalers (MDIs) are often polydisperse with a wide size range, so using monodisperse aerosols and/or count-based deposition quantification may lead to significant errors. The objective of this study was to develop a mass-based dosimetry method and evaluate its performance in lung delivery in a mouth-lung (G9) geometry with an albuterol-CFC inhaler. The conventional practices (monodisperse and polydisperse-count-based) were also simulated for comparison purposes. The MDI actuation in the open space was studied using both high-speed imaging and LES-Lagrangian simulations. Experimentally measured spray velocities and size distribution were implemented in the computational model as boundary conditions. Good agreement was achieved between recorded and simulated spray plume evolution spatially and temporally. The polydisperse-mass-based predictions of MDI doses compared favorably with the measurements in all three regions considered (device, mouth-throat, and lung). Significant errors in MDI regional deposition were predicted using the monodisperse and count-based methods. The new polydisperse-mass-based method also predicted local deposition hot spots that were one order of magnitude higher in intensity than the two conventional methods. The results of this study highlighted that a presentative polydisperse size distribution and appropriate deposition quantification method should be applied to reliably predict the MDI drug delivery in the human respiratory tract.