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Impact of constant and breath‐synchronized nebulization on inhaled mass of nebulized budesonide in infants and children
Author(s) -
Nikander Kurt,
Bisgaard H.
Publication year - 1999
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/(sici)1099-0496(199909)28:3<187::aid-ppul5>3.0.co;2-j
Subject(s) - nebulizer , budesonide , medicine , anesthesia , inhalation , aerosolization , crossover study , asthma , alternative medicine , pathology , placebo
The aim of the present study was to compare the output of a breath‐synchronized jet nebulizer to a conventional constant output nebulizer over a fixed period of time in terms of inhaled mass of budesonide, i.e., the amount of budesonide deposited on a filter interposed between the nebulizer and the face mask. One hundred and sixty‐five asthmatic children (103 boys) were enrolled in this open, randomized, crossover trial. Their age ranged from 6 months to 7.9 years, height from 69 to 132 cm, and weight from 8.2 to 31.3 kg. Their duration of asthma ranged from less than 1 to 7 years. Budesonide suspension, 0.5 mg mL −1 , 2 mL, was used. With 5 min of constant output nebulization, the mean inhaled mass of budesonide in percent of the nominal dose was 11.4% in the youngest children and 14.9% in the 7‐year‐old children. Expressed in percent of the total output of budesonide, i.e., the amount that left the nebulizer as an aerosol, the inhaled mass ranged from 34.6–48.6%. Thus, 51.4–65.4% of the total output was deposited on the expiratory filter. With 5 min of breath‐synchronized nebulization, the mean inhaled mass ranged from 10.5–14.9% of the nominal dose. For the youngest patients less than 3–4 years of age, it was approximately 80–90% of the total output. For the older patients the inhaled mass was approximately 95% of the total output, i.e., only small amounts of budesonide were deposited on the expiratory filter. For both modes of nebulization the between‐subject variation in inhaled mass was large: up to 6‐fold in the young children, and 3–4‐fold in the older ones. The results of the present study showed that the inhaled mass of budesonide was significantly age‐dependent with both modes of nebulization, i.e., the inhaled mass was less in younger children. Breath‐synchronized nebulization resulted in reduced waste of drug during expiration. Pediatr Pulmonol. 1999; 28:187–193. © 1999 Wiley‐Liss, Inc.