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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT06157515
Other study ID # BANinHealthy
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date March 1, 2024
Est. completion date May 24, 2024

Study information

Verified date February 2024
Source Chang Gung University
Contact Hui-Ling Lin, Ph.D
Phone +886-3-2118800
Email huiling@cgu.edu.tw
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The goal of this crossover study is to compare urine drug concentrations using a continuous vibrating mesh nebulizer versus a breath-actuated vibrating mesh nebulizer in healthy volunteers. The main questions it aims to answer are: - Whether breath-actuation nebulizer delivers higher inhaled drug dose, resulting in higher urine drug concentrations compared to continuous nebulization. - Whether the different nebulizer modes deliver inhaled drug resulting in different effects on physiological parameters, including heart rate, respiratory rate, blood pressure, and blood oxygen saturation. Participants will - Inhale one dose (2.5mg) of salbutamol via continuous vs. breath-actuated nebulize mode. - collect urine samples at multiple timepoints before and after nebulization to quantify drug elimination. Researchers will compare the continuous and breath-actuated modes of vibrating mesh nebulizers to determine if breath-actuation improves drug delivery efficiency compared to continuous nebulization.


Description:

Study Design and Objectives This is a crossover study comparing two different nebulizer modes: continuous vibrating mesh nebulizer (cVMN, Microbase Inc.) vs. breath-actuated vibrating mesh nebulizer (bVMN, Microbase plus an actuated system) for bronchodilator delivery in 30 healthy volunteers. The primary objective is to compare urinary drug concentrations after inhalation between the two nebulizer modes to confirm an equivalent inhaled dose. Secondary objectives is to evaluate device safety based on vital sign changes and compare environmental drug particle concentrations between nebulizer modes. Endpoints The primary pharmacokinetic endpoint is urinary drug (salbutamol) concentration over 24 hours following nebulization with each mode. Secondary endpoints include pre- and post-nebulization vital signs (heart rate, blood pressure, respiratory rate, Saturation). Study Procedures Participants meeting the eligibility criteria will be assigned either to the continuous vibrating mesh nebulizer (cVMN) or the breath-actuated vibrating mesh nebulizer (bVMN). At visit 1, a baseline urine sample will be collected, followed by nebulization with a 0.5-unit dose (2.5 mg/1.25 mL salbutamol). Participants will inhale with normal tidal breathing for up to 5 minutes until the aerosol is visually seen. Vital signs will be continuously monitored every 5 minutes until 30 minutes after nebulization. Environmental particle concentration will be continuously measured by an aerosol spectrometer. Urine samples will be obtained 30 minutes before, 30 minutes after, and 24 hours post-nebulization. Visit 2 will follow identical procedures with the alternate nebulizer mode after a 1-week washout period. Device Details The cVMN is a commercially available continuous vibrating mesh nebulizer registered with the Taiwan Food and Drug Administration (device number 004561). The bVMN system incorporates a proprietary trigger module to enable breath-actuated delivery synchronized during inspiration. This module includes microphone detection during inspiration and expiration phases, along with software control of nebulization activation. Both devices utilize the same core nebulizer hardware and mesh component for aerosol generation. Data Collection and Statistics Urine samples will be extracted and analysis by HPLC to quantify salbutamol levels. Statistical analysis will include paired t-tests or nonparametric tests as appropriate to compare pharmacokinetic parameters, environmental concentrations, and vital signs changes between the two nebulize modes. Linear regression will also correlate urinary drug levels with nominal dose. The level of significance will be p<0.05.


Recruitment information / eligibility

Status Recruiting
Enrollment 30
Est. completion date May 24, 2024
Est. primary completion date May 15, 2024
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 20 Years and older
Eligibility Inclusion Criteria: - Willing to sign a written informed consent form. - Healthy male and female participants aged >20 years. - Forced expiratory volume in the first second (FEV1) greater than 80% of the predicted value. Exclusion Criteria: - Pregnant or lactating women. - Regular use of bronchodilators or inhaled medications. - History of bronchodilator allergy. - Hyperthyroidism. - Diabetes. - History of heart disease. - Arrhythmia. - Angina. - Hypertension. - History of glaucoma, hypokalemia, or hyperglycemia. - Severe anemia. - Individuals with severe injuries or burns or limb amputation after breast surgery. - Open wounds or infectious dermatitis on the oral and facial regions. - Acute or infectious respiratory tract infections. - Currently taking any medications. - Respiratory therapy students.

Study Design


Related Conditions & MeSH terms


Intervention

Device:
Breath-actuated vibrating mesh nebulizer
The intervention utilizes a breath-actuated vibrating mesh nebulizer system consisting of a controller module with microphone for respiratory phase detection and algorithm for inspiration triggering. This interfaces with the vibrating mesh nebulizer module which incorporates a micro-pump chip using piezoelectric effects to eject fluid through a mesh aperture plate holes. By detecting the onset of inspiration based on characteristic acoustic patterns using machine learning models, the controller module sends signals activating the piezoelectric vibration mechanism to generate aerosol only during the inspiratory phase through precision timing control, shutting off mist during expiration. The core module is attached to a standard commercial vibrating mesh nebulizer using the standard adult reusable mouthpiece interface.
Continuous vibrating mesh nebulizer
When the continuous vibrating mesh nebulizer powered on, the micro-pump chip provides sustained vibrations onto the aperture plate, forcing fluid through micron-scale pores under pressure to continuously produce aerosol throughout inspiration and expiration phase.

Locations

Country Name City State
Taiwan Linkou Chang Gung Memorial Hospital Taoyuan

Sponsors (3)

Lead Sponsor Collaborator
Chang Gung University Chang Gung Memorial Hospital, National Tsing Hua University

Country where clinical trial is conducted

Taiwan, 

References & Publications (21)

Acharya J, Basu A. Deep Neural Network for Respiratory Sound Classification in Wearable Devices Enabled by Patient Specific Model Tuning. IEEE Trans Biomed Circuits Syst. 2020 Jun;14(3):535-544. doi: 10.1109/TBCAS.2020.2981172. Epub 2020 Mar 18. — View Citation

Chamberlain D, Kodgule R, Ganelin D, Miglani V, Fletcher RR. Application of semi-supervised deep learning to lung sound analysis. Annu Int Conf IEEE Eng Med Biol Soc. 2016 Aug;2016:804-807. doi: 10.1109/EMBC.2016.7590823. — View Citation

Charleston-Villalobos S, Martinez-Hernandez G, Gonzalez-Camarena R, Chi-Lem G, Carrillo JG, Aljama-Corrales T. Assessment of multichannel lung sounds parameterization for two-class classification in interstitial lung disease patients. Comput Biol Med. 2011 Jul;41(7):473-82. doi: 10.1016/j.compbiomed.2011.04.009. Epub 2011 May 14. — View Citation

Christiani DC, Kern DG. Asthma risk and occupation as a respiratory therapist. Am Rev Respir Dis. 1993 Sep;148(3):671-4. doi: 10.1164/ajrccm/148.3.671. — View Citation

Denyer J, Dyche T. The Adaptive Aerosol Delivery (AAD) technology: Past, present, and future. J Aerosol Med Pulm Drug Deliv. 2010 Apr;23 Suppl 1(Suppl 1):S1-10. doi: 10.1089/jamp.2009.0791. — View Citation

Denyer J, Prince I, Dixon E, Agent P, Pryor J, Hodson M. Evaluation of the Target Inhalation Mode (TIM) breathing maneuver in simulated nebulizer therapy in patients with cystic fibrosis. J Aerosol Med Pulm Drug Deliv. 2010 Apr;23 Suppl 1(Suppl 1):S29-36. — View Citation

Dhand R. Intelligent nebulizers in the age of the Internet: The I-neb Adaptive Aerosol Delivery (AAD) system. J Aerosol Med Pulm Drug Deliv. 2010 Apr;23 Suppl 1(Suppl 1):iii-v. doi: 10.1089/jamp.2010.0818. No abstract available. — View Citation

Dhand R. New frontiers in aerosol delivery during mechanical ventilation. Respir Care. 2004 Jun;49(6):666-77. — View Citation

Dimich-Ward H, Wymer ML, Chan-Yeung M. Respiratory health survey of respiratory therapists. Chest. 2004 Oct;126(4):1048-53. doi: 10.1378/chest.126.4.1048. — View Citation

Dolovich MB, Dhand R. Aerosol drug delivery: developments in device design and clinical use. Lancet. 2011 Mar 19;377(9770):1032-45. doi: 10.1016/S0140-6736(10)60926-9. Epub 2010 Oct 29. — View Citation

Geller DE, Kesser KC. The I-neb Adaptive Aerosol Delivery System enhances delivery of alpha1-antitrypsin with controlled inhalation. J Aerosol Med Pulm Drug Deliv. 2010 Apr;23 Suppl 1(Suppl 1):S55-9. doi: 10.1089/jamp.2009.0793. — View Citation

Heinzerling A, Stuckey MJ, Scheuer T, Xu K, Perkins KM, Resseger H, Magill S, Verani JR, Jain S, Acosta M, Epson E. Transmission of COVID-19 to Health Care Personnel During Exposures to a Hospitalized Patient - Solano County, California, February 2020. MMWR Morb Mortal Wkly Rep. 2020 Apr 17;69(15):472-476. doi: 10.15585/mmwr.mm6915e5. — View Citation

Islam MA, Bandyopadhyaya I, Bhattacharyya P, Saha G. Multichannel lung sound analysis for asthma detection. Comput Methods Programs Biomed. 2018 Jun;159:111-123. doi: 10.1016/j.cmpb.2018.03.002. Epub 2018 Mar 9. — View Citation

Kern DG, Frumkin H. Asthma in respiratory therapists. Ann Intern Med. 1989 May 15;110(10):767-73. doi: 10.7326/0003-4819-110-10-767. — View Citation

Lipworth BJ. Pharmacokinetics of inhaled drugs. Br J Clin Pharmacol. 1996 Dec;42(6):697-705. doi: 10.1046/j.1365-2125.1996.00493.x. — View Citation

Loeb M, McGeer A, Henry B, Ofner M, Rose D, Hlywka T, Levie J, McQueen J, Smith S, Moss L, Smith A, Green K, Walter SD. SARS among critical care nurses, Toronto. Emerg Infect Dis. 2004 Feb;10(2):251-5. doi: 10.3201/eid1002.030838. — View Citation

Messner E, Fediuk M, Swatek P, Scheidl S, Smolle-Juttner FM, Olschewski H, Pernkopf F. Multi-channel lung sound classification with convolutional recurrent neural networks. Comput Biol Med. 2020 Jul;122:103831. doi: 10.1016/j.compbiomed.2020.103831. Epub 2020 May 23. — View Citation

Nikander K, Prince I, Coughlin S, Warren S, Taylor G. Mode of breathing-tidal or slow and deep-through the I-neb Adaptive Aerosol Delivery (AAD) system affects lung deposition of (99m)Tc-DTPA. J Aerosol Med Pulm Drug Deliv. 2010 Apr;23 Suppl 1(Suppl 1):S3 — View Citation

Sen I, Saraclar M, Kahya YP. A Comparison of SVM and GMM-Based Classifier Configurations for Diagnostic Classification of Pulmonary Sounds. IEEE Trans Biomed Eng. 2015 Jul;62(7):1768-76. doi: 10.1109/TBME.2015.2403616. Epub 2015 Feb 12. — View Citation

Seren E. Frequency spectra of normal expiratory nasal sound. Am J Rhinol. 2005 May-Jun;19(3):257-61. — View Citation

Yeo LY, Friend JR, McIntosh MP, Meeusen EN, Morton DA. Ultrasonic nebulization platforms for pulmonary drug delivery. Expert Opin Drug Deliv. 2010 Jun;7(6):663-79. doi: 10.1517/17425247.2010.485608. — View Citation

* Note: There are 21 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Urinary salbutamol concentration Quantitative measurement of salbutamol levels in urine samples at protocol-specified timepoints before and after nebulized bronchodilator administration using high performance liquid chromatography (HPLC). Urine samples will be collected at 30 minutes before nebulization, at 30 minutes, and 24 hours after nebulization.
Secondary Heart rate Heart rate measured via continuous telemetry Heart rate will be recorded continuously from 5 minutes before, during, and 30 minutes, and after nebulization.
Secondary Blood pressure Systolic and diastolic blood pressure Blood pressure will be recorded from 5 minutes before, during, and 30 minutes after nebulization.
Secondary Saturation Oxygen saturation using a pulse oximeter. Oxygen saturation will be recorded from 5 minutes before, during, and 30 minutes after nebulization.
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