Aerosol Deposition Study

Aerosol Deposition Study

Being Alive Newsletter, Being Alive/Los Angeles - May 1993
John Lewis

Volunteers who were HIV+ and had T4 counts of less than 100 were recruited for our study. Patients with active infection, a history of previous adverse reaction to AP or severe asthma were excluded.

To study the effectiveness of this method, deposition scans were performed after our volunteers inhaled AP "tagged" with technetium 99 and Human Serum Albumin (HSA). The HSA causes the Technetium to "tag" the pentamidine so we could truly observe the deposition of AP. We performed this study using three different combinations:

- Group one was sitting and breathing irregularly, reading and with no specific technique,

- Group two was lying down, again with no specific breathing technique,

- Group three was sitting and performing the TLCT.

We first performed equilibrium xenon scans on our patients to define lung margins and volumes. We then took deposition scans during and after each aerosol inhalation, and these were superimposed on the xenon scans.

Our results showed the TLCT had by far the lowest asymmetry index. The medication was distributed more evenly throughout the lung fields.

The normal breathing pattern with an irregular breath hold was by far the least efficient. There was a large amount of medication that was lost in the main bronchus never reaching the alveolar area.

I called over to a hospital that specializes in AIDS care and asked them how their patient's receive pentamidine. Every one of them incorporates the irregular breathing pattern method. Some turn patients from side to side or place them in the supine position.
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