Because the two methods of oral and injection medication bring inconvenience to people, and as the side effects of antibiotics continue to be exposed, people begin to feel confused and fearful. The third method of drug delivery - aerosol inhalation drug delivery is becoming more and more widely known!

01

Disadvantages of traditional drug delivery—oral medicine

For many parents, "feeding the baby medicine" after the baby becomes ill is a nightmare in parenting life. The baby cries loudly, kicks its legs, and shakes its head left and right to resist. It is often two or three people who take turns to hold the baby，fixing their head, clamping their calves, the medicine is often spilled everywhere, not much medicine can enter the mouth, sometimes a little bit of it is finally poured in, and the baby vomits it all out. It is not only wasting medicine but the effectiveness of the medicine is reduced by half, which is really a headache.

02

Disadvantages of traditional drug delivery—injection

It mainly refers to intramuscular injection, which is the injection and infusion that we come into contact with daily. This method can cause muscle pain, so adults and children alike will want to run away from the needle.

In addition to the traditional oral or injection drug, is there other way to choose?

For respiratory diseases, a third mode of drug delivery is used

Aerosol inhalation

03

The third way of dosing for humans - aerosol inhalation

In many countries, the main treatment of respiratory diseases is aerosol inhalation. By using the nebulizer to disperse the liquid into small droplets, inhaled through the nose or mouth of the patient, the atomized drug directly acts on the target organ, that is, directly delivers the drug to the inflammation site, which can improve the local concentration of the drug and achieve the therapeutic effect. It is called the third drug delivery method, which avoids the pain caused by traditional oral and injection, and the drug only needs one-tenth of the oral drug and one-thirtieth of the injection drug, with fewer side effects, which is especially important for children.

Aerosol inhalation administration only through breathing can achieve the therapeutic effect, children will not be afraid to resist, for parents, of course, willing to choose this safe and easy way of administration! It is worth mentioning that atomized inhalation has a very good therapeutic effect on bronchiolitis, asthmatic bronchitis, bronchial asthma, acute and chronic bronchitis, acute laryngitis, acute pneumonia, etc.

04

Portable nebulizer - home nebulization becomes a trend

As major hospitals continue to widely use the third drug delivery method - atomized inhalation therapy, people treat respiratory diseases, atomization has become the first choice.

With the development of science and technology, people atomize more and more toward family atomization.

Feellife, founded in 2013, is an international medical enterprise integrating the study, research, production, and sales of nebulizer and nebu-liquid. With the vision of "The Third Way of Dosing" and the technology core of "AiMesh ®" polymer nebulizer, feellife owns more than 250+ international invention patents and certificates, taking the leading position in the field of nebulized drug delivery, and the clinical nebulization equipment for hospital intensive care represented by "AirICU" has already benefited millions of patients in more than 40 countries and regions.

wechat ID: lfsmedical

A research paper on a randomized controlled trial of bronchodilator delivery via high-flow nasal cannula (HFNC). The primary purpose of the study was to compare the effectiveness of bronchodilator delivery at different gas flow settings. The patients involved in the study all had a history of chronic obstructive pulmonary disease (COPD) or asthma and had a clear positive response to inhaled bronchodilators in an outpatient pulmonary function laboratory.

In the study, patients were randomly assigned to three different gas flow settings: GF:IF = 0.5, GF:IF = 1.0, and GF = 50 L/min. In these settings, patients inhaled saline (control group) and then received different doses of salbutamol via HFNC at 0.5 mg, 1.5 mg, 3.5 mg, and 7.5 mg respectively. After each inhalation, a pulmonary function test is performed to assess the effect of bronchiectasis.

The study results showed that in the setting of GF:IF = 0.5, patients had a better response to a lower dose of salbutamol (1.5 mg), compared with the setting of GF:IF = 1.0 and GF = 50 L/min, reaching A higher proportion of patients expected improvement in lung function. This suggests that in HFNC therapy, setting the gas flow to 50% of the patient's peak inspiratory flow may deliver the drug more efficiently.

In addition, the study also explored the impact of different gas flow settings on drug delivery efficiency and found that a lower GF:IF ratio (such as 0.5) is more efficient in drug delivery efficiency and may reduce the required drug dose, thereby improving the effectiveness of treatment. Safety and economy. Overall, this study provides important clinical data for the use of HFNC in respiratory therapy, supporting the importance of optimizing gas flow settings under specific conditions.

At the same time, it can be seen in the article that using a vibrating mesh nebulizer (VMN) to deliver the bronchodilator albuterol through a high-flow nasal cannula (HFNC) has certain advantages:

Higher inhalation dose and lower line condensation deposits. The article points out that the VMN is placed on the dry side of the HFNC humidifier, so that a higher inhalation dose and lower pipeline condensation deposition can be obtained.

Higher drug delivery efficiency. The results showed that under the airflow setting of GF:IF=0.5, patients responded better to a lower dose (1.5 mg) of salbutamol, and a higher proportion of patients achieved expected lung function improvement. This means that the VMN can deliver drugs more efficiently at this airflow setting.

Introduction

Acute respiratory distress syndrome (ARDS) is a severe lung condition that can lead to respiratory failure. Inhaled iloprost, a prostacyclin analogue, is a treatment for ARDS that can help to improve lung function. However, the short half-life of iloprost means that it must be administered frequently, which can be inconvenient for patients and caregivers.

Inspiration-synchronized nebulization (ISN) is a method of delivering inhaled medication that is synchronized with the patient's breathing cycle. This can help to improve drug delivery to the lungs and reduce side effects.

In a recent study, researchers compared the use of ISN with continuous nebulization (CN) for the delivery of inhaled iloprost to mechanically ventilated patients. The study found that ISN was more effective than CN at delivering iloprost to the lungs and that it could be used to deliver iloprost for a longer period of time.

Methods

The study was an in vitro model that used a test lung to simulate the human lung. The test lung was connected to a ventilator that was set to either volume-controlled ventilation (VC-CMV) or pressure-controlled ventilation (PC-CMV) mode. Two types of nebulizers were used: an inspiration-synchronized vibrating mesh nebulizer (VMNsyn) and a continuous vibrating mesh nebulizer (VMNcont).

VMNcont：continuous vibrating mesh nebulizer

VMNsyn：inspiration-synchronized vibrating mesh nebulizers

The researchers measured the aerosol output of the nebulizers and the nebulization time. They also compared the deposition of iloprost in the test lung with the two nebulization methods.

Results

The aerosol output of the VMNsyn was significantly lower than the aerosol output of the VMNcont for both ventilation modes. However, the nebulization time of the VMNsyn was significantly longer than the nebulization time of the VMNcont. This resulted in a similar total amount of iloprost being delivered by the two nebulizers.

Iloprost deposition rate. The deposition rates of the two nebulizers during VC-CMV showed no significant differences, while during PC-CMV, the VMNsyn reached a significantly lower deposition rate. During VC-CMV, the iloprost deposition rate of the inspiration-synchronized VMN (VMNsyn) was higher than during PC-CMV, however without being statistically significant (p = 0.05). The deposition rate of the continuous VMN (VMNcont) also did not differ between the two ventilation modes.

Discussion

The results of this study suggest that ISN is a more effective method of delivering inhaled iloprost to mechanically ventilated patients than CN. ISN can deliver iloprost for a longer period of time and results in a higher deposition of iloprost in the lungs.

These findings may have implications for the treatment of ARDS. ISN could be used to deliver inhaled iloprost to patients with ARDS for a longer period of time, which could improve patient outcomes.

Conclusion

Inspiration-synchronized nebulization during VC-CMV mode seems to be the most suitable for prolonged inhalative iloprost administration in mechanically ventilated patients.

Additional points

The study was conducted in an in vitro model, so the results may not be directly applicable to clinical practice.More research is needed to confirm the efficacy of ISN in the treatment of ARDS.

Reference

Otto, M.; Kropp, Y.; Jäger, E.; Neumaier, M.; Thiel, M.; Quintel, M.; Tsagogiorgas, C. The Use of an Inspiration-Synchronized Vibrating Mesh Nebulizer for Prolonged Inhalative Iloprost Administration in Mechanically Ventilated Patients—An In Vitro Model. Pharmaceutics 2023, 15, 2080.

When choosing the appropriate nebulizer type for mechanical ventilation therapy, the studies have found that it can have a significant impact on patient bioaerosol emissions and ventilation parameters. The results of this study are significant and have far-reaching implications for clinical practice and disease transmission control.

Closed circuit reduces risk of pulmonary edema in mechanical ventilation

During simulated mechanical ventilation, disconnection of the ventilator circuit to replenish JN medication resulted in the release of patient-derived bioaerosols and a decrease in the ventilation parameter PEEP. Crucially, refilling of the JN results in a decrease in pressure within the circuit, which may lead to pulmonary edema.

Open system dosing can cause aerosol contamination

Maintaining a closed pressurized circuit during mechanical ventilation is critical to ensure safe controlled ventilation of the patient and to reduce risks associated with patient-derived bioaerosols. Studies have shown that nebulizer choice affects the release of patient-derived bioaerosols to the local environment, with more particles being released into the environment during use of open-system jet nebulizers. Data confirm that patient-derived bioaerosols may be released into the local environment during mechanical ventilation when the ventilation circuit is interrupted during refilling of the jet nebulizer. During refill of the VMN, the ventilation circuit remained intact and, therefore, no particles were released during drug refill, validating guidance indicating that mesh nebulizers can be used during mechanical ventilation.

 The feellife AirlCU nebulizer is a medical mesh nebulizerthat can be used in combination with a ventilatorfor the nebulization of aerosols.

AiMesh® empowered, AirlCU has two nebulization modes: inductionmode (trigger mode) and continuousmode.Induction nebulization mode can only beused in conjunction with a ventilator that canprovide aerosol inspiratory therapy to patientswho cannot breathe on their own to meet thenebulization needs of different patients.

The Arab Health Exhibition, the second-largest global medical exhibition, stands out as the largest and most comprehensive professional medical expo in the Middle East. Since its inaugural event in 1975, the exhibition has consistently expanded in scale, attracting professionals from around the world. Arab Health 2024 will continue to adopt a combined "online + offline" format, with the physical exhibition taking place from January 29 to February 1, 2024, providing more possibilities for exchanges in the medical field.

Themed "Innovation and Healthcare Reform" in Arab Health 2023, the exhibition showcased thousands of medical products and services, drawing 3,358 exhibiting companies from 76 countries and over 135,880 industry professionals globally. The exhibition not only achieved a satisfaction rate of 96% but also generated a substantial total business value of up to USD 1.081 billion.

The rapid growth in the medical and healthcare sector in the Middle East is becoming a crucial market for suppliers of medical equipment and pharmaceutical products. Investments are projected to grow at an annual rate of 9%, with the total investment expected to reach USD 55 billion by 2025. Gulf countries, in particular, plan extensive medical construction projects to meet the increasing demands in healthcare.

Arab Health 2024 encompasses a wide range of exhibits, including medical equipment and instrument devices, home healthcare products, and small healthcare instruments. Whether it is medical electronic instruments, medical X-ray equipment, or home health care products, all will receive ample exposure at the exhibition.

Arab Health 2024 will continue to provide a platform for innovation in the medical industry, driving the development of the medical equipment sector and injecting new momentum into the healthcare industry in the Middle East and globally.

Feellife Health Inc. was founded in 2013, headquartered in Shenzhen, and is recognized as a national high-tech enterprise. feellife® focuses on the research and development, production, marketing, and services of nebulizer medical technology, covering various fields such as life healthcare, clinical medicine, and nebulized vaccines.

feellife® boasts a portfolio of 220+ core patents under AiMesh®, leading the innovation in intelligent variable-frequency nebulization technology. With a CNAS-certified standard laboratory, the company has successfully obtained international ISO13485 certification, national medical device Class II EU CE certification, and FDA certification in the United States. Its products are distributed across more than 60 countries and regions, including Europe, America, the Middle East, Southeast Asia, and East Asia.

Leveraging the patented AiMesh® nebulization core technology, feellife® holds a strong core competitive advantage in the international medical nebulization field. Through technological innovation driving product development, the company aims to meet the demands of nebulized medical care, contributing to the steady development of the nebulized medical sector.

In the upcoming Arab Health Exhibition, feellife® will continue to explore new trends in nebulized medical care, fully utilize its technological advantages, and actively pursue the vision of "providing a third way of dosing for humanity." The company is committed to delivering high-quality nebulized medical services and experiences to users globally.

feellife® founded in 2013, is an international medical enterprise integrating academics, research and development, production and sales of nebulizer and nebulizer solution, and is the first to create the global nebulization ecological model of intelligent nebulizer + nebulizer solution. We have a team of cutting-edge scientific research and technology talents, a one-stop full-service team, and cutting-edge production equipment. Decades of focus on the field of nebulization, based on the nebulization of medical technology industry. Globally, the first to develop the core innovative technology of AiMesh® nebulization, dedicated to the research of nebulization medical ecology, leading the forefront of nebulization technology. Provide the third way of drug delivery for human beings, and comprehensively enhance the change of nebulization for all human beings.

Since its establishment, it has passed ISO13485, GMP, CGMP, SO22000, CFDA, ROHS, SGS, FDA, CE and other safety certifications, and participated in the development of the "Mesh Nebulizer Registration Guidelines" national standard.

With innovative high-tech nebulization technology, solid safety quality, and through continuous in-depth exploration, feellife® increase scientific and technological research and development efforts to complete the AiMesh® nebulization core technology patent layout, to create core competitiveness in the field of medical nebulization, and become the first brand to fully realize the new upgrade of nebulization core technology. feellife® provides users with a better nebulization experience, and lays a solid foundation of the domestic nebulizer. Domestic nebulizer has laid a solid foundation of innovation and technology, enhance the market influence and popularity of domestic nebulizer brands, and help the nebulization medical field to leap forward.

What is AiMesh® Nebulizing Core Technology?

The secret of feellife® efficient, precise and safe atomization comes from AiMesh® atomization core technology.

It uses modern high-tech field of polymer materials, high-frequency oscillation technology, to achieve a high degree of precision uniform aperture, nebulization quality has been fundamentally safeguarded. Promote human nebulization medical level enhancement, service for all mankind high-quality nebulization.

Global Advantages of AiMesh® Nebulization Core Technology

feellife® relies on technology independent research and development, production line built independently to keep moving forward, layers of strict screening, standardized dust-free production workshop, to create high-quality nebulization. Craftsmanship to create a series of fine products such as mesh nebulizer, lung function tester, nebulized vaccine equipment.

Technology + Quality = Core Competitiveness

The technology developed quantitative atomized vaccine inhalation Air Right device, which realizes the precise quantitative drug delivery output technology, and the atomization precision can be as small as 10 μL, in order to quickly overcome the obstacles of large-scale vaccination, and was approved by the Guangdong Provincial Department of Science and Technology to prevent the epidemic of the strategic materials for the establishment of the project program.

Air Pro 5 nebulized inhalation vaccine equipment, has passed the new crown pneumonia epidemic prevention and control technology research special project. None of this does not verify that the feellife® AiMesh® nebulization core technology this technology for the future development of the field of nebulization is of great significance to promote! For the long-term development of enterprises that are deeply engaged in the fogging industry is crucial!

The fact that feellife® has maintained its market-leading position in the nebulizer field fully highlights the brand's philosophy of "customer first" and providing high-quality, safer, and smarter products at all times. The development of nebulization technology is not only to meet the global respiratory health, but also to explore the true value of nebulization technology. This is a change that is not limited to the quality of nebulization, but a change that serves all mankind!

Nebulized inhalation is a direct drug delivery method using the respiratory tract and lungs as the target organs, and has become a key means of treating respiratory-related diseases with its advantages of rapid onset of action, high local drug concentration, lower dosage, convenient application and fewer systemic adverse effects. However, unregulated use of nebulized inhalation therapy may not only directly impair the therapeutic effect, but also cause safety hazards, posing a threat to the life and health of patients.

Nebulized inhalation therapy uses a nebulized inhalation device to convert medication into aerosol particles with diameters ranging from 0.01 to 10 μm, which are inhaled and deposited in the airways and lungs to exert therapeutic effects. The diameter of the nebulized particles directly affects where the drug is deposited in the body, and effective nebulized particles should have a diameter between 0.5 and 10 μm. The effective nebulized particles should be between 0.5 and 10 μm in diameter. 5 to 10 μm diameter particles are mainly deposited in the oropharynx, 3 to less than 5 μm particles are mainly deposited in the lungs, and 50% to 60% of particles less than 3 μm are deposited in the alveoli.

Physicochemical properties of nebulized inhaled drugs

The widespread use of nebulized inhalation drugs has made them a key therapeutic tool for respiratory-related diseases. The therapeutic effect of this treatment is mainly due to its unique physicochemical properties, which optimize the action of the drug in the body.

Ideally, aerosolized inhaled drugs exhibit 'two short and one long' properties in vivo, which means that the drug has a shorter residence time at the surface of the airway mucosa, a relatively shorter plasma half-life, and a longer retention time in the local tissues. This characteristic helps to exert the therapeutic effect rapidly in a short period of time, reduce the occurrence of systemic side effects, and maintain the drug concentration in local tissues for a longer period of time to achieve a more lasting therapeutic effect.

In practice, inhaled glucocorticosteroids (ICS) are widely used for the treatment of COPD and asthma, short-acting β2 agonists (SABA) are used for the rapid relief of acute symptoms, short-acting cholinergic M-receptor antagonists (SAMA) inhibit mucus secretion from airway glands by blocking the cholinergic M-receptor and relaxing airway smooth muscle, diastolizing bronchioles, and mucolytics can inhibit mucus secretion from the airway glands by decreasing the phlegm's viscosity to increase sputum expulsion, thus making it easier to cough up.

Medication monitoring in special populations

First of all, the use of nebulized inhalation preparations in elderly patients requires comprehensive consideration of various factors to ensure the effectiveness and safety of medication. For the elderly population, medication compliance and accuracy are key, so measures need to be taken to improve patients' understanding of and cooperation with nebulized inhalation therapy. When applying inhaled glucocorticoids (ICS), particular attention needs to be paid to the risk of pneumonia in the elderly population. Different types of ICS may have different risks of developing pneumonia, so careful consideration needs to be given to their selection and use to ensure that elderly patients are able to maintain good respiratory hygiene during treatment.

For elderly patients with cardiac disease, the principle of inhalation on demand should be followed when nebulizing short-acting beta2 agonists (SABA). Overuse of SABA may lead to arrhythmias or aggravate symptoms of coronary artery disease, so patient response needs to be closely monitored to avoid unnecessary risks when administering the drug. In addition, the use of nebulized inhaled short-acting choline M receptor antagonist (SAMA) should be used more cautiously in elderly patients with prostatic hyperplasia or bladder cancer neck obstruction. The overall health of the patient needs to be taken into account when developing a treatment plan to avoid possible adverse effects and complications.

Second, when using nebulized inhalation formulations in pediatric patients, special attention needs to be paid to the safety and efficacy of the medication. Budesonide Suspension is currently approved by the U.S. Food and Drug Administration (FDA) as a nebulized dosage form of ICS for use only in children under 4 years of age. Dosage adjustments should be made as needed for nebulized inhalation therapy in children. To improve therapeutic efficacy, the use of a mask inhaler is recommended for younger children, especially if a closed mask is selected. The treatment should preferably be carried out in a quiet state to ensure the relaxation and comfort of the child.

During treatment, the vital signs of the pediatric patient need to be closely monitored. If symptoms such as frequent coughing, shortness of breath,   and airway spasm occur, nebulization treatment should be immediately suspended and observed. After the symptoms are relieved, the suitability of continuing the treatment needs to be assessed. For children who need long-term nebulization therapy, regular follow-up should be conducted to assess the effectiveness of the treatment. Parents should not stop the medication on their own because their child is showing improvement; adjustments need to be made on the advice of the doctor.

Finally, women need special care when using nebulized inhalation preparations during pregnancy and lactation. According to clinical guidelines issued by the NAEPP Expert Panel and ACOG, for those pregnant and breastfeeding women with persistent asthma, the preferred medications for controlling airway inflammation are ICSs, with budesonide having an FDA pregnancy classification of B, and beclomethasone propionate and fluticasone propionate having a C classification. The results of the Swedish Birth Registration Center study showed no significant effect of budesonide treatment on congenital malformations, fetal death, gestational age, or fetal growth. Therefore, budesonide is recommended as the preferred choice for nebulized inhalation formulations during pregnancy and lactation.

In addition, according to a statement from the American Academy of Pediatrics (AAP), terbutaline has very limited excretion in breast milk and therefore may be preferred as a SABA for use in nursing women.This recommendation is intended to ensure that when a woman uses a nebulized inhalation formulation while breastfeeding, the potential effects of the medication on the infant are minimized. When choosing a medication regimen, women should make decisions under the advice and guidance of their physician to maintain their own health and that of their infant.

In terms of medication monitoring for special populations, for different groups of people such as elderly patients, pediatric patients, pregnant and lactating women, we need to pay more attention to the safety and rationality of medication, to ensure that patients receive nebulized inhalation therapy with optimal therapeutic effects and reduce the risk of adverse reactions.

Nebulized inhalation therapy, as a method of direct drug delivery, has significant advantages in the treatment of respiratory-related diseases. However, we also need to realize that unregulated use may negatively affect the therapeutic efficacy and safety of patients, and even threaten their lives and health. In the future, we look forward to the continuous innovation and development of nebulized inhalation therapy, which will bring patients a more convenient, safer and more effective treatment experience. The in-depth research and practice of this treatment modality will continue to expand the prospects of nebulized medicine and open up new possibilities for the treatment of respiratory diseases. Let's work together to bring the potential of nebulized inhalation therapy into full play and provide a third way of drug delivery for human beings.