The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Regional Deposition of Aerosolized Pentamidine: Effects of Body Position and Breathing Pattern

Martin I. Baskin, MD; Antoine G. Abd, MD; and Jonathan S. Ilowite, MD
[+] Article, Author, and Disclosure Information

Grant Support: In part by the Stony Wald-Herbert Fund, Lyphomed, Inc., and Cadema Corporation.

Requests for Reprints: Jonathan S. Ilowite, MD, Pulmonary Division, Winthrop University Hospital, 222 Station Plaza North, Suite 400, Mineola, NY 11501.

Current Author Addresses: Drs. Baskin and Abd: Division of Pulmonary and Critical Care Medicine, St Luke's/Roosevelt Hospital Center, Amsterdam Avenue and 114th Street, New York, NY 10025.

Dr. Ilowite: Pulmonary Division, Winthrop University Hospital, 222 Station Plaza North, Suite 400, Mineola, NY 11501.

© 1990 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1990;113(9):677-683. doi:10.7326/0003-4819-113-9-677
Text Size: A A A

Objective: To evaluate the effects of varying body position and breathing pattern on overall lung distribution of aerosolized pentamidine.

Design: Nonrandomized control trial with four weekly inhalational treatments.

Setting: The nuclear medicine department of a voluntary hospital.

Patients: Sixteen men with the acquired immunodeficiency syndrome (AIDS) or positive serology for the human immunodeficiency virus (HIV). Thirteen patients (81%) completed the study.

Interventions: Patients inhaled a solution of either saline and technetium-99m bound to diethylenetriamine penta-acetic acid or sterile water, pentamidine (60 mg), and technetium-99m bound to human serum albumin. On weekly visits, the patients inhaled the aerosol solution using four methods: sitting, supine, sitting with an abdominal binder, and sitting and breathing from residual volume with a shallow inspiration.

Measurements and Main Results: Deposition scans, obtained after each aerosol inhalation, were superimposed on each patient's equilibrium xenon scan, and a frequency distribution histogram was constructed. An asymmetry index was determined from this histogram. The lower the asymmetry index, the more homogeneous the aerosol distribution. Only use of the supine position showed a significant decrease in the asymmetry index (mean, 0.34 ± 0.02 in the supine position, 0.48 ± 0.03 in the sitting position; P < 0.001).

Conclusions: Aerosol distribution in the lungs was more uniform when administered to patients in the supine position. Patients receiving aerosolized pentamidine may benefit from inhalation in the supine position; these results should be verified by clinical study.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.