Variation in Pediatric Aerosol Delivery: Importance of Facemask
Publication: Journal of Aerosol Medicine
Volume 18, Issue Number 3
Abstract
We have quantified in vitro the influence of the facemask on the amount of drug delivered (e.g., inhaled mass) by jet nebulizer and pressurized metered dose inhaler (pMDI) valved holding chamber (VHC) combinations (non-detergent-coated and detergent-coated). Pediatric breathing patterns were used with a breathing simulator, which was connected to a face onto which each device was positioned. An inhaled mass filter interposed between the simulator and the face captured the aerosolized drug. Budesonide inhalation suspension (0.25 mg) was used with the jet nebulizers and fluticasone propionate (220 µg) pMDI with the VHCs. Maximal drug delivery was measured using constant flow through each device. Breathing pattern effects were assessed for sealed devices (no leaks) and with facemasks (possible leaks at the facemask). Inhaled mass from both nebulizers and pMDI VHCs was affected by breathing pattern, but compared to nebulizers the pMDI VHCs were significantly more variable and sensitive to several factors. The influence of VHC conditioning combined with effects of breathing pattern resulted in the inhaled mass ranging from 0.7 ± 0.5 to 53.3 ± 6.2%. Nebulizers were less variable (9.6 ± 0.7 to 24.3 ± 3.1%). Detergent coating of VHC markedly increased the inhaled mass and reproducibility of drug delivery (27.2 ± 1.4 to 53.3 ± 6.2%) for pMDI VHC combinations, but these effects were lost in the presence of facemasks. Using pediatric patterns of breathing, nebulizer/facemask combinations delivered 4.1 ± 0.8 to 19.3 ± 2.3% of the label dose while pMDI and detergent-coated VHC delivered 4.0 ± 1.6 to 28.6 ± 2.5%. Facemask seal is a key factor in drug delivery. Leaks around the facemask reduce drug delivery and for pMDI VHCs can negate effects of detergent coating.
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Copyright 2005, Mary Ann Liebert, Inc.
History
Published online: 23 September 2005
Published in print: Fall 2005
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