Nanocluster budesonide formulations enhance drug delivery through endotracheal tubes

The pulmonary system is an attractive route for drug delivery because the lungs have a large accessible surface area for treatment. For ventilated patients, an endotracheal tube is required for delivering drugs into the lungs. Such tubes are generally poor conduits for delivering traditional aerosol formulations. Both the formulation and the properties of the endotracheal tube are important effectors of delivery efficiency. In this study, agglomerates of budesonide nanoparticles (NanoClusters) were formulated with or without l-leucine or lactose. Teflon tubing was compared with commercial endotracheal tubes as a conduit for delivering budesonide powders into a cascade impactor. The effects of volumetric flow rate, tube size, and humidity were also investigated. NanoCluster budesonide (NC-Bud) formulations had a considerably higher emitted dose and fine particle fraction compared with stock budesonide and the commercial Flexhaler powder when applied through endotracheal tubes. Tubing material did not significantly affect powder performance, but decreasing tubing diameter or increasing volumetric flow rates yielded a smaller mass median aerodynamic diameter for NC-Bud. Engineered NC-Bud powders may dramatically improve drug delivery through endotracheal tubes when using proper ventilator settings.