A hybrid in vitro in silico framework for albuterol delivery through an adult ventilator circuit to a patient-specific lung airway model

Abstract An integrated in vitro in silico approach was employed to investigate albuterol administration to an adult lung airway. Particle size characterization of aerosolized albuterol generated by a jet- and vibrating mesh nebulizer was evaluated in vitro using an adult ventilator circuit that consisted of an endotracheal tube (ETT) connected to a cooled Next Generation Impactor. The aerosol particle size distribution sampled by spectrophotometry was used to predict particle deposition in an in silico patient-specific seven-generation airway model using computational fluid dynamics (CFD). A Lagrangian particle tracking algorithm was used to investigate the effect of nebulizer type and position on drug delivery and compare the efficacy of drug administration through endotracheal intubation and oral route. A vibrating mesh nebulizer produced a larger lung dose than the jet nebulizer, with the aerosol characteristics being dependent on the location of the nebulizer in the ventilator circuit. The CFD analysis showed that the vibrating mesh nebulizer placed at the ventilator had a lower global and local deposition fraction down to the 7th airway generation with higher penetration beyond. Besides, delivery through the ETT was more efficient than oral delivery for the studied conditions. Particle deposition patterns in the various lung lobes were evaluated. Placement of the nebulizer in an adult ventilator circuit could target different areas of the lung.