title: Influence of Tracheostomy on Lung Deposition in Spontaneously Breathing Patients.
abstract: BACKGROUND
  Nebulized drugs are frequently administrated through tracheostomy in clinical routine. So far, the amount of drug deposited into the lung in these patients remains unknown. The aim of our pharmacokinetic study was to compare lung delivery of amikacin in the same subjects in two settings: spontaneously breathing through a tracheostomy and through the mouth.
  
  
  METHODS
  Lung delivery was measured by amikacin urinary drug concentration in nine patients who were transitory tracheostomized for the need of a head and neck oncologic surgery. Patients performed two nebulization sessions: with a mouthpiece (MB) and through tracheostomy (TB) using a adapted jet nebulizer (Sidestream®).
  
  
  CONCLUSIONS
  Lung delivery was similar with the two conditions of nebulization (6.5 ± 2.5% vs. 6.3 ± 2.0% of the nominal mass of amikacin, respectively, for MB and TB; p = 0.95). Duration of nebulization was also comparable (19.7 ± 1.6 vs. 20.1 ± 1.8 min, respectively, for mouth and tracheostomy breathing; p = 0.307). The half-life and elimination rate constant were not different between the two settings. We conclude that nebulized therapy can be administered in spontaneously breathing tracheostomized adults patients, with a similar amount of drug delivered to the lung compared with spontaneously mouth breathing patients.
authors.affiliation: 1 Department of Oral and Maxillofacial Surgery, Cliniques Universitaires Saint-Luc , Brussels, Belgium .|2 Institut de Recherche Expérimentale and Clinique (IREC), Pôle Pneumologie, ORL & Dermatologie, Université catholique de Louvain (UCL) , Brussels, Belgium .
authors.forename: Laurent
authors.initials: L
authors.lastname: Pitance
authors.affiliation: 2 Institut de Recherche Expérimentale and Clinique (IREC), Pôle Pneumologie, ORL & Dermatologie, Université catholique de Louvain (UCL) , Brussels, Belgium .|3 Department of Pneumologie, Cliniques Universitaires Saint-Luc , Brussels, Belgium .
authors.forename: Grégory
authors.initials: G
authors.lastname: Reychler
authors.affiliation: 4 Faculté de Médecine, DTF-Aerodrug , Tours, France .|5 Centre d'Etude des Pathologies Respiratoires INSERM U1100/EA6305, Université François Rabelais de Tours , Faculté de Médecine, Tours, France .
authors.forename: Laurent
authors.initials: L
authors.lastname: Vecellio
authors.affiliation: 2 Institut de Recherche Expérimentale and Clinique (IREC), Pôle Pneumologie, ORL & Dermatologie, Université catholique de Louvain (UCL) , Brussels, Belgium .|6 Louvain Centre for Toxicology and Applied Pharmacology (LTAP).
authors.forename: Teresinha
authors.initials: T
authors.lastname: Leal
authors.affiliation: 1 Department of Oral and Maxillofacial Surgery, Cliniques Universitaires Saint-Luc , Brussels, Belgium .|2 Institut de Recherche Expérimentale and Clinique (IREC), Pôle Pneumologie, ORL & Dermatologie, Université catholique de Louvain (UCL) , Brussels, Belgium .
authors.forename: Hervé
authors.initials: H
authors.lastname: Reychler
authors.affiliation: 2 Institut de Recherche Expérimentale and Clinique (IREC), Pôle Pneumologie, ORL & Dermatologie, Université catholique de Louvain (UCL) , Brussels, Belgium .|3 Department of Pneumologie, Cliniques Universitaires Saint-Luc , Brussels, Belgium .
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Liistro
keywords: artificial airways; nebulization; respiratory drug delivery; tracheostomy