Comparative analysis between peristaltic and syringe nebulization systems: Advancing high-pressure drug delivery for pressurized intraperitoneal aerosol chemotherapy (PIPAC).

BACKGROUND

The high-pressure syringe pump (HP-SP) is the most widely applied device for PIPAC. However, HP-SP systems exhibited several limitations: relatively more drug assembly procedures and significant start-up delays. Herein, the performance of a high-pressure peristaltic pump (HP-PP) was compared to the existing HP-SP for PIPAC.

METHODS

Mechanical and ex vivo experiments were conducted to compare the performance of the HP-PP and HP-SP for PIPAC. The evaluated parameters included (1) particle size distribution, operational pressure, and its influence on particle size distribution in the initial phase; (2) drug assembly time (DAT); (3) dead volume; (4) spray cone angle and deposition areas; and (5) doxorubicin (DOX) penetration depth and spatial distribution in a box model.

RESULTS

Both systems produced aerosols with comparable median particle sizes (≈25 μm) and spray cone angles (≈70°). The HP-PP demonstrated significantly shorter start-up time (5 s vs. 34.7 ± 2.9 s) and DAT (15.1 ± 1.3 s vs. 54.8 ± 3.1 s for a 150 mL setup). The original dead volume of HP-PP was 2.4 ± 0.3 mL but was reduced to 0.44 ± 0.03 mL after optimization. Spray coverage was similar for both pumps across different nozzle heights. DOX penetration depths were similar between groups, except for marginally deeper penetration at obstructed (B) and lateral (C) positions for HP-PP (p < 0.01).

CONCLUSION

The HP-PP performs comparably to the HP-SP in key aerosol and distribution parameters, while offering faster initiation and a simplified drug assembly process. This indicates its potential application for clinical PIPAC, despite no therapeutic advantage being observed at this stage.