Abstract
BACKGROUND: Aerosol drug delivery is widely used in treating respiratory conditions, but the patient's breathing pattern can significantly influence its effectiveness. This study investigates the impact of normal, obstructive, and restrictive breathing patterns on aerosol drug delivery with jet and mesh nebulizers in a simulated model of spontaneously breathing adults. METHODS: A spontaneously breathing adult was simulated using a teaching manikin (Nasco Healthcare) connected to a breathing simulator (QuickLung Breather; IngMar Medical Inc). A collecting filter (CareFusion) was placed distal to the bifurcation of the mainstem bronchi and connected to the breathing simulator. Albuterol sulfate (2.5 mg/3 mL) was delivered with jet (MistyMax 10) and mesh nebulizers (Aerogen Ultra). Each experiment was conducted in triplicate (n = 3), comparing drug delivery across six breathing patterns: (1) normal, (2) moderate obstruction, (3) severe obstruction, (4) moderate restriction, (5) severe restriction, and (6) combined obstruction and restriction. Data analysis included the Friedman ANOVA, uncorrected Dunn's test, and paired t-tests with Holm-Sidak's multiple comparison test (GraphPad Prism 10.3), with statistical significance set at p < 0.05. RESULTS: Our findings indicate that obstructive, restrictive, and combined breathing patterns significantly reduce aerosol deposition with jet and mesh nebulizers compared to normal breathing (p < 0.05). Aerosol delivery with the mesh nebulizer was up to 3-fold more than the jet nebulizer regardless of the breathing pattern tested in this study (p < 0.05). CONCLUSIONS: This study highlights the necessity for tailored aerosol therapy strategies to optimize drug delivery in patients with different respiratory conditions..