Total deposition of therapeutic particles during spontaneous and controlled inhalations

Treatment of systemic diseases by means of the inhalation route is hampered by uncertainties of the drug dose applied by inhalation. In this study, the hypothesis was tested that by standardization of the breathing maneuver used for inhalation, the interindividual variability of the dose deposited intrathoracically can be reduced. Therefore, breathing pattern during routine inhalations with jet nebulizers was measured in 18 patients with lung disease. Using monodisperse 3 microm particles, total deposition was then assessed for the measured spontaneous and for three controlled, slow breathing patterns. Particle deposition for the three controlled breathing patterns was additionally measured in 14 healthy subjects. The study has shown that within the study population the inhaled air volume and flow rate were quite different. Consequently, total particle deposition varied between 20 and 95%, depending on breathing pattern. For controlled, slow breathing patterns, deposition was on average higher, intersubject variability of deposition was smaller, and differences in deposition between healthy subjects and patients were negligible. Therefore, to perform efficient systemic treatment with aerosolized drugs, controlled, slow breathing patterns should be used.