Innovation for preterm neonates: breath-triggered delivery of medical aerosols

Inhalation therapy is an effective method for pharmacological treatment of respiratory diseases. A drawback of continuous drug delivery is the waste of (expensive) medication during exhalation. Development of a breath-triggered drug delivery system can significantly reduce this waste. To date, however, there is no such technology available for preterm infants and neonates, due to their challenging respiratory parameters. Researchers of the Fraunhofer ITEM Division of Translational Biomedical Engineering have developed a system that optically detects neonatal breathing and releases the aerosol directly at the patient interface in a breath-triggered manner. The hallmarks of this system are:

•  Up to 300 ms faster detection of the inhalation and exhalation phases compared to a flow sensor (gold standard)
• Integration of a fast (< 25 ms) aerosol valve at the patient interface and thus close to the patient
• Release of aerosol boluses at different inhalation time points, targeting different lung regions

Compared to the clinical standard system, this system can achieve a 4.2-fold higher dose efficiency. This is to be confirmed in a clinical trial with the glucocorticoid budesonide in preterm infants as part of the EU MDOT project in early 2023. The new method has great potential for use in preterm infants and neonates in the future. In view of both economic and ecological improvements, the technology may also be used in adults.