Table 1 Summary of the advantages and disadvantages of the four delivery methods evaluated
Technique | Anatomic Target | Advantages | Disadvantages |
|---|---|---|---|
Intranasal | - Nasal epithelium - Tracheal epithelium - Proximal aspect of lung lobes | - Relatively quick - Little skill/training required - Can be performed by one person - Inexpensive - Best option if wanting to target the upper respiratory tract - Can administer multiple doses | - Frequent loss of vector due to swallowing - Inefficient delivery to the lower respiratory tract |
Modified intranasal | - Nasal epithelium - Tracheal epithelium - Proximal to middle aspect of lung lobes | - Relatively quick - Little skill/training required - Inexpensive - Least variable delivery method - Can administer multiple doses | - Requires two people - Does not reach the distal aspect of lung lobes |
Intubation | - Nasal epithelium - Tracheal epithelium - Proximal, middle and distal aspect of lung lobes | - Method that most consistently reaches the distal aspect of the lung lobes - Can be performed by one person | - Technically challenging - Requires more equipment than the other methods - Variable - Time consuming - Possibility of losing vector if esophagus is penetrated - Excessive swelling prevents repeated attempts at intubation |
Intratracheal | - Nasal epithelium - Tracheal epithelium - Proximal to middle aspect of lung lobes - Possible to target distal aspect of lung lobes | - Primarily targets the lower respiratory tract - Limited delivery to the nasal epithelium - Can be performed by one person, but is easier with two people | - Technically challenging - Requires surgical skills - Variable - Invasive - Requires analgesic - Re-administration not advised if done more than 5Â days after initial administration |