In Vitro Evaluation of a Vibrating-Mesh Nebulizer Repeatedly Use over 28 Days

Rationale: Intrauterine growth restriction (IUGR) increases the risk of bronchopulmonary dysplasia (BPD), one of the major complications of prematurity. Antenatal low-protein diet (LPD) exposure in rats induces IUGR and mimics BPD-related alveolarization disorders. Proliferator-activated receptor (PPARg) plays a key role in normal lung development and was found deregulated following LPD exposure. Objectives: Investigate the effects of nebulized curcumin, a natural PPARg agonist, to prevent IUGR-related abnormal lung development. Methods: We studied rat pups antenatally exposed to an LPD or control diet (CTL) and treated with nebulized curcumin (50 mg/kg) or vehicle from postnatal (P) days 1 to 5. The primary readouts were lung morphometric analyses at P21. Immunohistochemistry (P21) and microarrays (P6 and P11) were compared within animals exposed to LPD versus controls, with and without curcumin treatment. Results: Quantitative morphometric analyses revealed that LPD induced abnormal alveolarization as evidenced by a significant increase in Mean Linear Intercept (MLI) observed in P21 LPD-exposed animals. Early curcumin treatment prevented this effect and two-way ANOVA analysis demonstrated significant interaction between diet and curcumin both for MLI (F(1,39)=12.67,p=0.001) and Radial Alveolar Count at P21 (F(1,40)= 6.065, p=0.0182). Immunohistochemistry for FABP4, a major regulator of PPARg pathway showed a decreased FABP4+ alveolar cell density in LPD-exposed animals treated by curcumin. Transcriptomic analysis showed that early curcumin significantly prevented the activation of pro-fibrotic pathways observed at P11 in LPD-exposed animals. Conclusion: Nebulized curcumin appears to be a promising strategy to prevent alveolarization disorders in IUGR rat pups, targeting pathways involved in lung development.

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“…1A). A previous study showed that the mass median aerodynamic diameter of what produced by this device ranged from 3.56 to 3.68 mm (12).…”

Section: Methodsmentioning

confidence: 92%

Nebulized curcumin protects neonatal lungs from antenatal insult in rats

Guillier

Carrière

Pansiot

et al. 2021

American Journal of Physiology-Lung Cellular and Molecular Phys

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“…Similar to a previous study ( 21 ), we found the highest aerosol delivery of JN to be lower than that of i-JN, and that the delivery of VMN was the highest. VMN has gained clinical popularity because of its quiet operation, relatively high efficiency, low residual volume, minimal influence on ventilation parameters, minimal disruption of ventilation, and no release with a closed-circuit VMN compared to JN ( 22 – 25 ). However, many factors influence aerosol delivery during invasive mechanical ventilation, including the position of the nebulizer in the ventilator circuit ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

Position of different nebulizer types for aerosol delivery in an adult model of mechanical ventilation

Hou

Xu²,

Dai³

et al. 2022

Front. Med.

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BackgroundThe optimal positions of different types of nebulizer for aerosol delivery remain unclear.MethodsThree ICU ventilators employing three types of nebulizer were separately connected to a simulated lung to simulate nebulization during invasive ventilation. Assist/control-pressure control (A/C-PC) mode was utilized, with inspiratory pressure (Pi) set to 12 cmH2O and positive end expiratory pressure (PEEP) set to 5 cmH2O, and with a target Vt of 500 ml. The bias flow of all the ventilators was set to 2 L/min. The three nebulizers were the continuous jet nebulizer (c-JN), the inspiratory synchronized jet nebulizer (i-JN), and the vibrating mesh nebulizer (VMN). The five nebulizer positions were as follows: at the Y-piece (position 1) and 15 cm from the Y-piece (position 2) between the endotracheal tube and the Y-piece, at the Y-piece (position 3) and 15 cm from the Y-piece (position 4) in the inspiratory limb; and at the humidifier inlet (position 5). Aerosols were collected with a disposable filter placed at the simulated lung outlet (n = 3) and were measured by UV spectrophotometry (276 nm). The measurements were compared under different experimental conditions.ResultsThe aerosol delivery of c-JN, i-JN, and VMN was 5.33 ± 0.49~11.12 ± 0.36%, 7.73 ± 0.76~13.75 ± 0.46% and 11.13 ± 56–30.2 ± 1.63%, respectively. The higher aerosol delivery: for c-JN~Positions 2 (10.95 ± 0.15%), fori-JN~Positions 1 or 2 (12.91 ± 0.88% or 13.45 ± 0.42%), for VMN~Positions 4(29.03 ± 1.08%); the lower aerosol delivery: for c-JN~Positions 1, 3 or 5, fori-JN~Positions 4 or 5, for VMN~Positions 5.The highest aerosol delivery:For c-JN at Position 2 (10.95 ± .15%), for i-JN at Position 1 or 2 (12.91 ± .88% or 13.45 ± .42%), for VMN at Positions 4 (29. 03 ± 1.08%); the lower aerosol delivery: for c-JN at Positions 1, 3 or 5, for i-JN at Positions 4 or 5, for VMN at Positions 5. The highest aerosol deliveryof c-JN was lower than that of i-JN while the VMN was the highest (all P < .05). However, no differences were observed between the highest aerosol delivery with c-JN and the lowest aerosol delivery with i-JN. Similar results were found between the lowest aerosol delivery with VMN and the highest aerosol delivery with c-JN /i-JN in the Avea ventilator. There were no differences in the highest aerosol delivery of each nebulizer among the different ventilators (all p > 0.05).ConclusionDuring adult mechanical ventilation, the type and position of nebulizer influences aerosol delivery efficiency, with no differences between ventilators.

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“…The demistifier and any drug remaining in the nebulizer or IV tubing were placed into a red biohazard bag along with the large bore tubing, T adaptor, aerosol mask and O2 reduce, and disposed according to institutional policy. While vibrating-mesh nebulizer has been re-used for 28 days with albuterol, given the potential for the crystals to block the membrane the nebulizer was only used for 24 h and then replaced with a new device [13]. Upon completion of the last prescribed treatment, the same process was followed including the demistifier canopy, aerosol tubing and mask.…”

Section: Methodsmentioning

confidence: 99%

The Aerogen® Solo Is an Alternative to the Small Particle Aerosol Generator (SPAG-2) for Administration of Inhaled Ribavirin

et al. 2020

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Respiratory syncytial virus (RSV) is associated with adverse outcomes among immunocompromised patients. Inhaled ribavirin has been shown to improve mortality rates. The Small-Particle Aerosol Generator delivery system (SPAG-2) is the only FDA-cleared device to deliver inhaled ribavirin. However, it is difficult to set up and maintain. We developed a method for delivery of this medication using the vibrating mesh nebulizer (Aerogen®). We did not observe any adverse events with this method.

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In Vitro Evaluation of a Vibrating-Mesh Nebulizer Repeatedly Use over 28 Days

Cited by 13 publications

References 18 publications

Nebulized curcumin protects neonatal lungs from antenatal insult in rats

Nebulized curcumin protects neonatal lungs from antenatal insult in rats

Position of different nebulizer types for aerosol delivery in an adult model of mechanical ventilation

The Aerogen® Solo Is an Alternative to the Small Particle Aerosol Generator (SPAG-2) for Administration of Inhaled Ribavirin

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