CIMIT Summer Series 2009: Frontiers of Inhalation Technologies in Biomedical Sciences and Clinical Medicine
Week Two: TREATMENT OF RESPIRATORY DISEASES
Moderator: Dean Hess, PhD, Assistant Director of Respiratory Care, Massachusetts General Hospital; Associate Professor of Anesthesia, Harvard Medical School
Inhalation Technology for Obstructive Lung Disease
Sabine Häussermann, PhD, Chief of Medical Device Development, Air Liquide
While helium/oxygen (He/O2) mixtures have been described in clinical use since 1934, consensus over their range of clinical applications has been slow to emerge. The physical properties of He/O2 mixtures appear to be valuable in a variety of respiratory care applications. Inhaling He/O2 reduces the resistance to gas flow and hence reduces the work of breathing. In addition, breathing these mixtures alters the distribution of ventilation within the lung and could potentially improve aerosol delivery.
With increasing interest in He/O2 for severely ill patients, He/O2 delivery methods have evolved from spontaneous mask breathing up to latest-generation mechanical ventilators. Until recently, administering He/O2 has required modifications by doctors, respiratory therapists and their technicians on devices which were not designed for the use with He/O2, but for air and oxygen. This caused problems, especially with regard to flow measurement, and therefore led to uncertainty in the volumes delivered to the patients. Sabine Häussermann will review the use of He/O2 in practice and described current devices which are available to deliver the gas.
Aerosolized Drugs in Medicine: Where are They?
Gerald C. Smaldone, MD, PhD, Professor of Medicine, Physiology and Biophysics at the State University of New York at Stony Brook
Aerosols have significant potential as new medical therapeutics both targeted to the lungs or for systemic drug delivery. This belief has stimulated the formation of new companies, many new innovations in technology and potential therapies. However, no aerosol drug has been successful in impacting medical practice since aerosolized pentamidine was approved 20 years ago. Beyond the usual therapies in asthma and COPD, physicians do not recognize aerosols as viable treatments for any other diseases. In twenty years of observation and research, a model of aerosol development has emerged at Stony Brook that might lead to new therapies. This model comprises three key components: (1) perceived need by practicing physicians, (2) local expertise in aerosol technology and medicine (3) recognition of the business needs in bringing a drug to medical practice. According to Dr. Gerald Smaldone, failure of any one of these components may prevent the emergence of new therapeutics.
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