A multi-nozzle nebuliser does not improve tissue drug delivery during PIPAC

Area of Science:

• Oncology
• Drug Delivery Systems
• Medical Devices

Background:

• Pressurized intraperitoneal aerosol chemotherapy (PIPAC) utilizes multi-nozzle nebulizers to enhance homogeneous tissue drug delivery.
• Previous studies have not conclusively demonstrated the superiority of multi-nozzle over single-nozzle PIPAC devices.
• This study aimed to compare the performance of multi- and single-nozzle nebulizers in PIPAC applications.

Purpose of the Study:

• To compare the physical and pharmacological performance of multi-nozzle and single-nozzle (Capnopen®) PIPAC nebulizers.
• To evaluate aerosol characteristics, tissue drug delivery, and drug distribution homogeneity.
• To determine if multi-nozzle devices offer advantages over the Capnopen® in ex vivo models.

Main Methods:

• Physical experiments: aerosol droplet size analysis (laser diffraction spectroscopy) and spatial spray pattern visualization on blotting paper.
• Pharmacological experiments: ex vivo bovine urinary bladder model for real-time tissue drug delivery assessment.
• Evaluation of doxorubicin and cisplatin tissue distribution and concentration for both nebulizer types.

Main Results:

• Multi-nozzle nebulizer exhibited greater aerosolization flow and wider spray angle but larger particle sizes.
• Tissue drug delivery rates were comparable; aerosol sedimentation showed no significant difference between devices.
• Capnopen® achieved higher doxorubicin and cisplatin tissue concentrations, with significantly better cisplatin distribution homogeneity.

Conclusions:

• The multi-nozzle PIPAC nebulizer did not outperform the single-nozzle Capnopen® in ex vivo drug delivery and homogeneity.
• Despite broader spray patterns, the multi-nozzle device resulted in lower tissue drug concentrations.
• Capnopen® demonstrated superior performance regarding tissue drug concentration and homogeneity, particularly for cisplatin.