Effects of multi-electrode electrostatic precipitation during intraperitoneal aerosolized drug delivery: Insights from a large animal model.

Intraperitoneal aerosolized drug delivery (IPADD) has emerged as a promising local treatment approach for peritoneal metastasis (PM). However, its effectiveness is currently limited by uneven aerosol distribution and restricted tumor tissue penetration. The use of electrostatic precipitation (ESP) exerts an electric force, which may enhance aerosol distribution and tissue penetration. A methylene blue (MB) solution was delivered intraperitoneally as an aerosol during laparoscopy in female pigs. Animals were randomized to receive either IPADD alone or IPADD combined with ESP. Tissue samples were taken from the ventral and lateral abdominal wall and from the small bowel. Aerosol distribution was evaluated using semiquantitative scoring of MB staining. Tissue penetration was measured on cryosections. Systemic resorption was assessed via serial blood sampling. Compared to IPADD alone, ESP clearly improved MB distribution, specifically in regions away from the nebulizer, and appreciably enhanced the tissue penetration in abdominal wall and small bowel samples. Sequenced activation of the three electrodes produced the most pronounced effects. ESP did not increase systemic exposure, and no tissue damage was observed. In this large animal model, multi-electrode ESP safely enhanced aerosol distribution and tissue penetration during IPADD, showing potential to improve treatment in patients with PM.