Evaluation of a system for the delivery of inhaled beclomethasone dipropionate to intubated neonates | JoVE Visualize

Evaluation of a system for the delivery of inhaled beclomethasone dipropionate to intubated neonates

¹Department of Pediatrics, Medical College of Virginia, Richmond.

Developmental Pharmacology and Therapeutics|January 1, 1991

View abstract on PubMed

Summary

A new system delivers aerosolized beclomethasone dipropionate (BDP) to intubated neonates, offering a safer alternative to systemic dexamethasone for bronchopulmonary dysplasia treatment. This method ensures a majority of particles are respirable, potentially improving treatment efficacy.

Area of Science:

Neonatal Medicine
Respiratory Pharmacology
Drug Delivery Systems

Background:

Systemic dexamethasone for bronchopulmonary dysplasia (BPD) carries significant side effects.
There is a need for safer, targeted steroid delivery in neonates with BPD.

Purpose of the Study:

To develop and evaluate an in vitro system for aerosolized beclomethasone dipropionate (BDP) delivery to intubated neonates.
To assess the impact of endotracheal tube (ETT) size and spacer length on BDP delivery.

Main Methods:

A novel delivery system comprising a self-inflating bag, metered dose inhaler (MDI) adapter, spacer, and ETT was designed.
In vitro testing measured BDP output using different ETT sizes and spacer lengths.
Particle size distribution was analyzed to determine respirable fraction.

Main Results:

The system successfully delivered aerosolized BDP, with no significant difference in drug output across varying ETT sizes (3.0 mm vs. 3.5 mm).
A shorter system spacer significantly reduced BDP output.
Over 54% of particles exiting the ETT were within the respirable range (0.5-5.5 microns).

Conclusions:

The developed system provides an effective in vitro method for targeted aerosolized BDP delivery to intubated neonates.
This approach may offer a safer and more efficacious alternative to systemic dexamethasone for managing BPD.
Estimated neonatal dosage is 1-6 doses per day, considering lung size and adult BDP delivery data.