This study was presented at the British Thoracic Society Winter Meeting 2022.

Does Spacer/Adapter Device Choice Affect Delivery of a Pressurized Metered Dose Inhaler (pMDI) through a Humidified Circuit to a Simulated Patient on Mecha

Medications to manage care of bronchiectasis and NTM patients are often delivered via a nebulizer. This study compares a number of different OPEP/Nebulizer combinations using salbutamol as the modelled medication.

Asthma impacts different people in different ways. Most people are able to control their asthma with regular use of their controller medication and using their reliever medication when necessary. However, for many it can be difficult to recognize when their asthma is not controlled. When asthma is well-controlled, you will experience little to no asthma symptoms.

New information regarding the efficiency and effectiveness of different oscillating positive expiratory pressure devices was presented at CHEST 2017 in Toronto, Canada.

Medications to manage care of bronchiectasis and NTM patients are often delivered via a nebulizer. This study compares a number of different OPEP/Nebulizer combinations using salbutamol as the modelled medication.

Asthma impacts different people in different ways. Most people are able to control their asthma with regular use of their controller medication and using their reliever medication when necessary. However, for many it can be difficult to recognize when their asthma is not controlled. When asthma is well-controlled, you will experience little to no asthma symptoms.

The FRI deposition profiles highlighted significant differences between the VHCs on test, with intrathoracic delivery for the AeroChamber Plus* Flow-Vu* VHC system being almost double that of the other two VHC systems and being similar to the MDI alone with perfect coordination

As current MDIs contain hydrofluorocarbon propellants, it would be beneficial to find ways to reduce carbon emissions without compromising patient safety.

This lab study investigated a way to optimize the modelled lung dose per actuation while at the same time minimizing the carbon emissions from the MDI

Conclusions:

COPD/chronic bronchitis patients given an Aerobika* OPEP device compared to an alternative OPEP device had delayed time to re-admission. This supports use of the Aerobika* OPEP device as an add-on to usual care post-exacerbation and highlights differences in OPEP device effectiveness.

COPD/chronic bronchitis patients given an Aerobika* OPEP device compared to an alternative OPEP device had delayed time to re-admission. This supports use of the Aerobika* OPEP device as an add-on to usual care post-exacerbation and highlights differences in OPEP device effectiveness.

CONCLUSIONS

• A systematic review of nebulizer use highlighted a few different potential mechanisms for fugitive emissions. Differences in nebulizer design had an impact in the amount and type of fugitive emissions emitted.
• Through the choice of an appropriate nebulizer, the natural risk can be greatly reduced, and through selection of appropriate mitigation strategies, the risk can be almost eliminated.

Conclusions:

• The DPI results suggest that inhalation breathing profiles can have an appreciable impact upon aerosol delivery, with one participant having much less predicted medication as fine particles
• In contrast, although the inhalation profiles across all participants were also divergent when asked to inhale from the pMDI + VHC, either tidal breathing or by a slow, deep inhalation, all volunteers would have received a relatively consistent amount of medication.
• It also appears that the pMDI + VHC platform delivers a larger FPM<5.0 µm for both APIs and a consequently smaller coarse particle mass. However, it is recognized that more investigation is warranted with a larger number of volunteers and with other passive DPIs having different resistances

More consistent dose delivery was achieved with the breath actuated technology rather than breath enhanced.
Delivering medication only when the patient inhales would result in more stable therapy if I:E ratio was to change with disease< progression or if the patient took breaks to talk during treatment.

This laboratory study compared the performance of four different OPEP devices, each utilizing distinctly different mechanisms to generate oscillatory pressure.

Asthma control and global warming are important issues that have significant impacts on human health and the environment.

It is critical however to ensure that maintaining or improving the patient’s asthma control goes hand in hand with environmental actions.

This lab study investigated how to optimize the modelled lung delivery while at the same time minimizing the carbon emissions from the MDI.