ArticleJournal of aerosol medicine and pulmonary drug delivery2017
Factors Determining In Vitro Lung Deposition of Albuterol Aerosol Delivered by Ventolin Metered-Dose Inhaler.
Article in Journal of aerosol medicine and pulmonary drug delivery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02447575 (Detecting Errors In Using Metered Dose Inhalers), which is not on this map. Cited by 10 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Detecting Errors In Using Metered Dose Inhalers (MDI) Among Asthma And Chronic Obstructive Pulmonary Disease (COPD) Patients
Who cites it
10 citing papers in PubMed.
- In vitro characterisation of fluticasone propionate and ciclesonide delivered with and without valved holding chambers using cascade impaction and an adult simulated breathing profile.BMJ open respiratory research · 2026Article
- The Advanced Integrated Respiratory (AIR) Model: Comparative Analysis of Salbutamol Sulphate Deposition from pMDI, DPI, and Nebuliser Versus the NGI.Pharmaceutical research · 2026Article
- How Breathing Interruptions Influence pMDI Aerosol Delivery: A CFD Study in a Realistic Airway.Pharmaceutical research · 2026Article
- Small airway dysfunction: a shared, early, measurable, and potentially treatable trait across COPD, asthma, and fibrotic lung disease.Frontiers in medicine · 2026Review
- A Novel End-to-End Simulation Framework for Internal Flow in pMDIs: Coupled Modeling of Cavitation, Flash Boiling, and Atomization.AAPS PharmSciTech · 2025Article
- Flow Profiles Identify Sources of Poor Metered Dose Inhaler Technique: An Observational Study in Patients with Long-Term Pressurized Metered Dose Inhaler Use.CHEST pulmonary · 2025Article
- Optimizing Fluticasone Propionate and Ciclesonide pMDI Delivery: The Protective Role of Valved Holding Chambers Against Inhalation Timing Errors.Journal of asthma and allergy · 2025Article
- Lower Inspiratory Breathing Depth Enhances Pulmonary Delivery Efficiency of ProAir Sprays.Pharmaceuticals (Basel, Switzerland) · 2022Article
- ATTACHED, DETACHED and WITHOUT inhaler technique coaching tools to optimize pMDI use competence, asthma control and quality-of-life in asthmatic adults.Journal of thoracic disease · 2020Article
- Characterization and comparison ofRSC advances · 2019Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe effectiveness of metered-dose inhalers (MDIs) in delivering medication to the lungs highly depends on its correct usage technique. Current guidelines state optimal technique for high lung deposition should include a slow inhalation (>5 seconds) at an inspiratory flow rate of 30 L/min and inhaler actuation at the start of inhalation. However, these recommendations were based on clinical studies using CFC (chlorofluorocarbon)-MDIs and in vitro studies of HFA (hydrofluoroalkane)-MDIs using idealized MDI techniques of uniform inhalation and actuation, disregarding the nonuniform techniques of actual patients.
methodsTo better understand the effects of time-varying MDI usage parameters on lung deposition of aerosol delivered by an HFA-MDI, we conducted an in vitro study modeled on real-life variable inspiratory flow and actuation techniques recorded from 15 subjects with asthma/chronic obstructive pulmonary disease (COPD). We developed a model representing the time-varying inspiratory flow waveforms and actuation timings based on 43 MDI techniques recorded from patients. Furthermore, we constructed an in vitro experimental setup using a mouth-throat cast, programmable MDI actuator, and breath simulator to evaluate lung deposition for the MDI techniques derived from our model.
resultsHigh inspiratory flow rates, 60-90 L/min, consistently resulted in high in vitro lung deposition (>40%) of aerosol (albuterol delivered from Ventolin HFA-MDI) compared to 30 L/min when MDI actuation occurred in the first half of inhalation. Also, positive coordination resulted in higher in vitro lung deposition compared with negative or zero coordination (actuating before or at the start of inspiration). Furthermore, variation in coordination affected lung deposition more significantly (23%) than flow rate or duration of inspiration (≤5%).
conclusionsIn an in vitro experimental model based on inhalation data from patients with asthma and COPD, we demonstrated that aerosol lung deposition emitted from Ventolin HFA-MDI is most optimal for MDI actuation in the first half of inspiration at high flow rates (60-90 L/min).
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