Efficiency of aerosol medication delivery from a metered dose inhaler versus jet nebulizer in infants with bronchopulmonary dysplasia

✍ Scribed by Tai Fai Fok; Shelley Monkman; Myrna Dolovich; Shari Gray; Geoff Coates; Bosco Paes; Ferid Rashid; Michael Newhouse; Haresh Kirpalani

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 818 KB
• Volume: 21
• Category: Article
• ISSN: 8755-6863
• DOI: 10.1002/(sici)1099-0496(199605)21:5<301::aid-ppul5>3.0.co;2-p

✦ Synopsis

The best means for optimal delivery of drugs into lungs of infants with bronchopulmonary dysplasia (BPD) is uncertain. We aimed to measure radio-aerosol deposition of salbutamol by jet nebulizer and metered dose inhalers (MDI) in ventilated and non-ventilated BPD infants.

In a randomized, crossover sequence, salbutamol lung deposition was measured using an MDI (2 puffs or 200 1.9) or sidestream jet nebulizer (5 minutes of nebulization with 100 pg/kg) in 10 ventilated (mean birthweight, 1,101 g) and 13 non-ventilated (mean birthweight, 1,093 g) prematurely born infants. Non-ventilated infants inhaled aerosol through a face mask, connected to a nebulizer or an MDI and spacer (AerochambeP). Ventilated infants received aerosol from an MDI + MV15 Aerochamberm or a nebulizer inserted in the ventilator circuit. Lung deposition by both methods was low: mean (SEM) from the MDI was 0.67 (0.17)% of the actuated dose, and from the nebulizer it was 1.74 (0.21)% and 0.28 (0.04)% of the nebulized and initial reservoir doses, respectively. Corresponding figures for the ventilated infants were 0.98 (0.1 9)Yo from the MDI and 0.95 (0.23)Yo and 0.22 (0.08)Y0 from the nebulizer. In both groups, and for both methods of delivery, there was marked inter-subject variability in lung deposition and a tendency for the aerosol to be distributed to the central lung regions.