{"doi":"10.1089/jamp.2023.0023","title":"Tracheomalacia Reduces Aerosolized Drug Delivery to the Lung","abstract":"Rationale:Neonates with respiratory issues are frequently treated with aerosolized medications to manage lung disease or facilitate airway clearance. Dynamic tracheal collapse (tracheomalacia [TM]) is a common comorbidity in these patients, but it is unknown whether the presence of TM alters the delivery of aerosolized drugs. Methods:Fourteen infant subjects with respiratory abnormalities were recruited; seven with TM and seven without TM. Respiratory-gated 3D ultrashort echo time magnetic resonance imaging (MRI) was acquired covering the central airway and lungs. For each subject, a computational fluid dynamics simulation modeled the airflow and particle transport in the central airway based on patient-specific airway anatomy, motion, and airflow rates derived from MRI. Results:Less aerosolized drug reached the distal airways in subjects with TM than in subjects without TM: of the total drug delivered, less particle mass passed through the main bronchi in subjects with TM compared with subjects without TM (33% vs. 47%, p = 0.013). In subjects with TM, more inhaled particles were deposited on the surface of the airway (48% vs. 25%, p = 0.003). This effect becomes greater with larger particle sizes and is significant for particles with a diameter >2 μm (2–5 μm, p ≤ 0.025 and 5–15 μm, p = 0.004). Conclusions:Neonatal patients with TM receive less aerosolized drug delivered to the lungs than subjects without TM. Currently, infants with lung disease and TM may not be receiving adequate and/or expected medication. Particles >2 μm in diameter are likely to deposit on the surface of the airway due to anatomical constrictions such as reduced tracheal and glottal cross-sectional area in neonates with TM. This problem could be alleviated by delivering smaller aerosolized particles.","journal":"Journal of Aerosol Medicine and Pulmonary Drug Delivery","year":2023,"id":359945,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":10,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9638,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1110972,"name":"Christopher McKenzie","orcid":"0000-0003-3521-8758","position":1,"is_corresponding":false},{"id":347631,"name":"Erik B. Hysinger","orcid":"0000-0002-9222-898X","position":2,"is_corresponding":false},{"id":737109,"name":"Qiwei Xiao","orcid":"0000-0002-8276-1473","position":3,"is_corresponding":false},{"id":334470,"name":"Nara S. Higano","orcid":"0000-0002-6233-161X","position":4,"is_corresponding":false},{"id":319693,"name":"Jason C. Woods","orcid":"0000-0002-8080-7511","position":5,"is_corresponding":false},{"id":334471,"name":"Alister J. Bates","orcid":"0000-0002-8855-3448","position":6,"is_corresponding":false},{"id":334469,"name":"C.C. Gunatilaka","orcid":"0000-0003-2713-6533","position":0,"is_corresponding":true}],"reference_count":49,"raw_metadata":null,"created_at":"2026-07-19T01:13:57.361401Z","pmid":"38064481","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}