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Expert Review of Respiratory Medicine Volume 7, 2013 - Issue 6
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Reviews

Aerosol therapy in children: challenges and solutions

Arzu AriGeorgia State University, Division of Respiratory Therapy, Atlanta, GA 30302-4019, USACorrespondence[email protected]
&
James B FinkGeorgia State University, Division of Respiratory Therapy, Atlanta, GA 30302-4019, USACorrespondence[email protected]
Pages 665-672 | Published online: 09 Jan 2014

References

  • Ari A, Hess D, Myers TR, Rau JL. A Guide to Aerosol Delivery Devices for Respiratory Therapists. American Association for Respiratory Care, Dallas, TX, USA (2009).
  • Ari A, Fink J. Guidelines to aerosol devices in infants, children and adults: which to choose, why and how to achieve effective aerosol therapy? Expert Rev. Respir. Med. 5(4), 561–572 (2011).
  • Dolovich M, Fink J. Aerosols and devices. Respir. Care Clin. N. Am. 7, 131 (2001).
  • Fink J. Metered-dose inhalers, dry powder inhalers and transitions. Respir. Care 45, 623–635 (2000).
  • Fink J. Aerosol delivery to ventilated infants and pediatric patients. Respir. Care 49(6), 653–665 (2004).
  • Rubin B, Fink J. Aerosol therapy for children. Respir. Care Clin. N. Am. 7(2), 100–108 (2001).
  • Rubin B, Fink J. The delivery of inhaled medication to the young children. Pediatr. Clin. North Am. 50(3), 717–731 (2003).
  • Rau JL. The inhalation of drugs: advantages and problems. Respir. Care 50(3), 367–382 (2005).
  • Rau JL. Design principles of liquid nebulization devices currently in use. Respir. Care 47(11), 1257–1275; discussion 1275–1258 (2002).
  • Rubin BK. Air and soul: the science and application of aerosol therapy. Respir. Care 55(7), 911–921 (2010).
  • Rubin B, Fink J. Optimizing aerosol delivery by pressurized metered-dose inhalers. Respir. Care 50, 1191 (2005).
  • Dolovich MB, Ahrens RC, Hess DR et al. Device selection and outcomes of aerosol therapy: evidence-based guidelines: American College of Chest Physicians/American College of Asthma, Allergy, and Immunology. Chest 127(1), 335–371 (2005).
  • Dolovich MB, Dhand R. Aerosol drug delivery: developments in device design and clinical use. Lancet 377(9770), 1032–1045 (2011).
  • Dhand R. Nebulizers that use a vibrating mesh or plate with multiple apertures to generate aerosol. Respir. Care 47(12), 1406–1416; discussion 1416–1408 (2002).
  • Fink JB, Rubin BK. Aerosol and medication administration. In: Perinatal and Pediatric Respiratory Care. Czerviske MP, Barnhart SL (Eds). Elsevier Science, St. Louis, MO, USA (2003).
  • Wildhaber JH, Janssens HM, Pierart F, Dore ND, Devadason SG, Lesouef PN. High-percentage lung delivery in children from detergent-treated spacers. Pediatr. Pulmonol. 29(5), 389–393 (2000).
  • Dhand R, Dolovich M, Chipps B, Myers TR, Restrepo R, Farrar JR. The role of nebulized therapy in the management of COPD: evidence and recommendations. COPD 9(1), 58–72 (2012).
  • Rau JL. Practical problems with aerosol therapy in COPD. Respir. Care 51(2), 158–172 (2006).
  • Yilmaz O, Sogut A, Kose U, Sakinci O, Yuksel H. Influence of ambulatory inhaled treatment with different devices on the duration of acute asthma findings in children. J. Asthma 46(2), 191–193 (2009).
  • Alvine GF, Rodgers P, Fitzsimmons KM, Ahrens RC. Disposable jet nebulizers. How reliable are they? Chest 101(2), 316–319 (1992).
  • Berg E, Picard R. In-vitro delivery of budesonide from 30 jet nebulizer/compressor combinations using infant and child breathing patterns. Respir. Care 54(12), 1671–1678 (2009).
  • Hess D, Fisher D, Williams P, Pooler S, Kacmarek RM. Medication nebulizer performance. Effects of diluent volume, nebulizer flow, and nebulizer brand. Chest 110(2), 498–505 (1996).
  • Ari A, Areabi H, Fink JB. Evaluation of position of aerosol device in two different ventilator circuits during mechanical ventilation. Respir. Care 55(7), 837–844 (2010).
  • Ari A, Atalay OT, Harwood R, Sheard MM, Aljamhan EA, Fink JB. Influence of nebulizer type, position, and bias flow on aerosol drug delivery in simulated pediatric and adult lung models during mechanical ventilation. Respir. Care 55(7), 845–851 (2010).
  • Dhand R. New frontiers in aerosol delivery during mechanical ventilation. Respir. Care 49(6), 666–677 (2004).
  • Waldrep JC, Dhand R. Advanced nebulizer designs employing vibrating mesh/aperture plate technologies for aerosol generation. Curr. Drug Deliv. 5(2), 114–119 (2008).
  • Ari A. Optimal delivery of aerosol drugs in the pediatric/neonatal patient populations. AARC Times 33(8), 24–26 (2009).
  • Rubin BK. Pediatric aerosol therapy: new devices and new drugs. Respir. Care 56(9), 1411–1421; discussion 1421–1413 (2011).
  • Fink JB, Rubin BK. Problems with inhaler use: a call for improved clinician and patient education. Respir. Care 50(10), 1360–1374 (2005).
  • De Benedictis FM, Selvaggio D. Use of inhaler devices in pediatric asthma. Paediatr. Drugs 5(9), 629–638 (2003).
  • Deerojanawong J, Promsaka Na Sakolnakorn V, Prapphal N, Hanrutakorn C, Sritippayawan S. Evaluation of metered-dose inhaler administration technique among asthmatic children and their caregivers in Thailand. Asian Pac. J. Allergy Immunol. 27(2–3), 87–93 (2009).
  • Fink JB. Inhalers in asthma management: is demonstration the key to compliance? Respir. Care 50(5), 598–600 (2005).
  • Kamps AW, Van Ewijk B, Roorda RJ, Brand PL. Poor inhalation technique, even after inhalation instructions, in children with asthma. Pediatr. Pulmonol. 29(1), 39–42 (2000).
  • Dalby R, Spallek M, Voshaar T. A review of the development of Respimat Soft Mist Inhaler. Int. J. Pharm. 283(1–2), 1–9 (2004).
  • Hochrainer D, Holz H, Kreher C, Scaffidi L, Spallek M, Wachtel H. Comparison of the aerosol velocity and spray duration of Respimat Soft Mist inhaler and pressurized metered dose inhalers. J. Aerosol. Med. 18(3), 273–282 (2005).
  • Kesser KC, Geller DE. New aerosol delivery devices for cystic fibrosis. Respir. Care 54(6), 754–767; discussion 767–758 (2009).
  • Pitcairn G, Reader S, Pavia D, Newman S. Deposition of corticosteroid aerosol in the human lung by Respimat Soft Mist inhaler compared to deposition by metered dose inhaler or by Turbuhaler dry powder inhaler. J. Aerosol. Med. 18(3), 264–272 (2005).
  • Brand P, Hederer B, Austen G, Dewberry H, Meyer T. Higher lung deposition with Respimat Soft Mist inhaler than HFA-MDI in COPD patients with poor technique. Int. J. Chron. Obstruct. Pulmon. Dis. 3(4), 763–770 (2008).
  • Newman S, Busse W. Evolution of dry powder inhaler design, formulation and performance. Respir. Med. 96, 293 (2002).
  • Atkins PJ. Dry powder inhalers: an overview. Respir. Care 50(10), 1304–1312; discussion 1312 (2005).
  • Broeders ME, Molema J, Vermue NA, Folgering HT. Peak inspiratory flow rate and slope of the inhalation profiles in dry powder inhalers. Eur. Respir. J. 18(5), 780–783 (2001).
  • Chavan V, Dalby R. Effect of rise in simulated inspiratory flow rate and carrier particle size on powder emptying from dry powder inhalers. AAPS PharmSci. 2(2), E10 (2000).
  • National Asthma Education and Prevention Program. Expert Panel Report III: Guidelines for the Diagnosis and Management of Asthma. National Heart, Lung, and Blood Institute, Bethesda, MD, USA (2007).
  • Ari A, Fink JB. Effective bronchodilator resuscitation of children in the emergency room: device or interface? Respir. Care 56(6), 882–885 (2011).
  • Rubin BK. Nebulizer therapy for children: the device-patient interface. Respir. Care 47(11), 1314–1319 (2002).
  • Everard ML. Aerosol delivery to children. Pediatr. Ann. 35(9), 630–636 (2006).
  • Everard ML. Inhalation therapy for infants. Adv. Drug Deliv. Rev. 55(7), 869–878 (2003).
  • Janssens H, Tiddens H. Aerosol therapy: the special needs of young children. Pediatr. Respir. Rev. 7, S83–85 (2006).
  • Amirav I, Newhouse MT. Aerosol therapy in infants and toddlers: past, present and future. Expert Rev. Respir. Med. 2(5), 597–605 (2008).
  • Devadason SG. Recent advances in aerosol therapy for children with asthma. J. Aerosol. Med. 19(1), 61–66 (2006).
  • Janssens HM, Tiddens HA. Facemasks and aerosol delivery by metered dose inhaler-valved holding chamber in young children: a tight seal makes the difference. J. Aerosol. Med. 20(Suppl. 1), S59–63; discussion S63–S65 (2007).
  • Amirav I, Newhouse MT. Aerosol therapy with valved holding chambers in young children: importance of the facemask seal. Pediatrics 108, 389 (2001).
  • Esposito-Festen J, Ates B, Van Vliet F, Hop W, Tiddens H. Aerosol delivery to young children by pMDI-spacer: is facemask design important? Pediatr. Allergy Immunol. 16(4), 348–353 (2005).
  • Esposito-Festen JE, Ates B, Van Vliet FJ, Verbraak AF, De Jongste JC, Tiddens HA. Effect of a facemask leak on aerosol delivery from a pMDI-spacer system. J. Aerosol. Med. 17(1), 1–6 (2004).
  • Smaldone GC. Assessing new technologies: patient-device interactions and deposition. Respir. Care 50(9), 1151–1160 (2005).
  • Smaldone GC, Berg E, Nikander K. Variation in pediatric aerosol delivery: importance of facemask. J. Aerosol. Med. 18(3), 354–363 (2005).
  • Smaldone GC, Sangwan S, Shah A. Facemask design, facial deposition, and delivered dose of nebulized aerosols. J. Aerosol. Med. 20(Suppl. 1), S66–S75; discussion S75–S67 (2007).
  • Erzinger S, Schueepp KG, Brooks-Wildhaber J, Devadason SG, Wildhaber JH. Facemasks and aerosol delivery in vivo. J. Aerosol. Med. 20(Suppl. 1), S78–S83; discussion S83–S74 (2007).
  • Hayden J, Smith N, Woolf D, Barry P, O’callaghan C. A randomised crossover trial of facemask efficacy. Arch. Dis. Child. 89(1), 72–73 (2004).
  • Amirav I, Mandelberg A. Face masks for aerosols-there is more science. Pediatr. Pulmonol. 45(3), 221–223 (2010).
  • Amirav I, Newhouse MT. Review of optimal characteristics of face-masks for valved-holding chambers (VHCs). Pediatr. Pulmonol. 43(3), 268–274 (2008).
  • Sangwan S, Gurses BK, Smaldone GC. Facemasks and facial deposition of aerosols. Pediatr. Pulmonol. 37(5), 447–452 (2004).
  • Amirav I, Luder A, Chleechel A, Newhouse MT, Gorenberg M. Lung aerosol deposition in suckling infants. Arch. Dis. Child. 97(6), 497–501 (2012).
  • Rubin BK. Bye-bye, blow-by. Respir. Care 52(8), 981 (2007).
  • Lin HL, Restrepo RD, Gardenhire DS, Rau JL. Effect of face mask design on inhaled mass of nebulized albuterol, using a pediatric breathing model. Respir. Care 52(8), 1021–1026 (2007).
  • Restrepo RD, Dickson SK, Rau JL, Gardenhire DS. An investigation of nebulized bronchodilator delivery using a pediatric lung model of spontaneous breathing. Respir. Care 51(1), 56–61 (2006).
  • Amirav I, Balanov I, Gorenberg M, Groshar D, Luder AS. Nebuliser hood compared to mask in wheezy infants: aerosol therapy without tears! Arch. Dis. Child. 88(8), 719–723 (2003).
  • Amirav I, Oron A, Tal G et al. Aerosol delivery in respiratory syncytial virus bronchiolitis: hood or face mask? J. Pediatr. 147(5), 627–631 (2005).
  • Kugelman A, Amirav I, Mor F, Riskin A, Bader D. Hood versus mask nebulization in infants with evolving bronchopulmonary dysplasia in the neonatal intensive care unit. J. Perinatol. 26(1), 31–36 (2006).
  • Amirav I, Shakked T, Broday DM, Katoshevski D. Numerical investigation of aerosol deposition at the eyes when using a hood inhaler for infants—a 3D simulation. J. Aerosol. Med. Pulm. Drug Deliv. 21(2), 207–214 (2008).
  • Ari A, Harwood R, Sheard M, Dailey P, Fink JB. In vitro comparison of heliox and oxygen in aerosol delivery using pediatric high flow nasal cannula. Pediatr. Pulmonol. 46(8), 795–801 (2011).
  • Bhashyam AR, Wolf MT, Marcinkowski AL et al. Aerosol delivery through nasal cannulas: an in vitro study. J. Aerosol. Med. Pulm. Drug Deliv. 21(2), 181–188 (2008).
  • Rau JL. Determinants of patient adherence to an aerosol regimen. Respir. Care 50(10), 1346–1359 (2005).
  • Dompeling E, Oudesluys-Murphy AM, Janssens HM et al. Randomised controlled study of clinical efficacy of spacer therapy in asthma with regard to electrostatic charge. Arch. Dis. Child. 84(2), 178–182 (2001).
  • Bisgaard H, Anhoj J, Klug B, Berg E. A non-electrostatic spacer for aerosol delivery Arch. Dis. Child. 73(3), 226–230 (1995).
  • Anhoj J, Bisgaard H, Lipworth BJ. Effect of electrostatic charge in plastic spacers on the lung delivery of HFA-salbutamol in children. Br. J. Clin. Pharmacol. 47(3), 333–336 (1999).
  • Van Der Veen MJ, Van Der Zee JS. Aerosol recovery from large-volume reservoir delivery systems is highly dependent on the static properties of the reservoir. Eur. Respir. J. 13(3), 668–672 (1999).
  • Pierart F, Wildhaber JH, Vrancken I, Devadason SG, Le Souef PN. Washing plastic spacers in household detergent reduces electrostatic charge and greatly improves delivery. Eur. Respir. J. 13(3), 673–678 (1999).
  • Wildhaber J, Devadason S, Hayden M et al. Electrostatic charge on a plastic spacer device influences the delivery of salbutamol Eur. Respir. J. 9(19), 1943–1946 (1996).
  • Rau J. Delivery of aerosolized drugs to neonatal and pediatric patients. Respir. Care 36(6), 514–542 (1991).
  • Barry PW, O’callaghan C. The effect of delay, multiple actuations and spacer static charge on the in vitro delivery of budesonide from the Nebuhaler. Br. J. Clin. Pharmacol. 40(1), 76–78 (1995).
  • Wildhaber JH, Devadason SG, Eber E et al. Effect of electrostatic charge, flow, delay and multiple actuations on the in vitro delivery of salbutamol from different small volume spacers for infants. Thorax 51(10), 985–988 (1996).
  • Tal A, Golan H, Aviram M. Deposition pattern of radiolabeled salbutamol inhaled from a metered-dose inhaler by means of a spacer with mask in young children with airway obstruction. J. Pediatr. 128, 479–484 (1996).
  • Ritson S, Denyer J, Everard ML. Aerosol delivery systems acceptable to young children improve drug delivery. Thorax 53(Suppl. 4), A55 (1998).
  • Iles R, Lister P, Edmunds AT. Crying significantly reduces absorption of aerosolised drug in infants. Arch. Dis. Child. 81(2), 163–165 (1999).
  • Everard ML. Trying to deliver aerosols to upset children is a thankless task. Arch. Dis. Child 82(5), 428 (2000).
  • Murakami G, Igarashi T, Adachi Y et al. Measurement of bronchial hyperreactivity in infants and preschool children using a new method. Ann. Allergy 64(4), 383–387 (1990).
  • Fok T, Lam K, Ng P et al. Delivery of salbutamol to nonventilated preterm infants by metered-dose inhaler, jet nebulizer, and ultrasonic nebulizer. Eur. Respir. J. 12, 159 (1998).
  • Chua HL, Collis GG, Newbury AM et al. The influence of age on aerosol deposition in children with cystic fibrosis. Eur. Respir. J. 7(12), 2185–2191 (1994).
  • Salmon B, Wilson N, Silverman M. How much aerosol reaches the lungs of wheezy infants and toddlers? Arch. Dis. Child 65(4), 410–413 (1990).
  • Wildhaber JH, Dore ND, Wilson JM, Devadason SG, Lesouef PN. Inhalation therapy in asthma: nebulizer or pressurized metered-dose inhaler with holding chamber? In vivo comparison of lung deposition in children. J. Pediatr. 135(1), 28–33 (1999).
  • Fink J, Ari A. Aerosol delivery to intubated patients. Expert Opin. Drug Deliv. 10(8), 1077–1093 (2013).
  • Rotschild A, Solimano A, Puterman M, Smyth J, Sharma A, Albersheim S. Increased compliance in response to salbutamol in premature infants with developing bronchopulmonary dysplasia. J. Pediatr. 115(6), 984–991 (1989).
  • Denjean A, Guimaraes H, Migdal M, Miramand JL, Dehan M, Gaultier C. Dose-related bronchodilator response to aerosolized salbutamol (albuterol) in ventilator-dependent premature infants. J. Pediatr. 120(6), 974–979 (1992).
  • Geller DE. Comparing clinical features of the nebulizer, metered-dose inhaler, and dry powder inhaler. Respir. Care 50(10), 1313–1321 (2005).
  • Ari A, Restrepo RD. Aerosol delivery device selection for spontaneously breathing patients: 2012. Respir. Care 57(4), 613–626 (2012).
  • Hess DR. Aerosol delivery devices in the treatment of asthma. Respir. Care 53(6), 699–723 (2008).
  • Everard ML. Guidelines for devices and choices. J. Aerosol. Med. 14(Suppl. 1), S59–S64 (2001).
  • Devadason SG, Le Souef PN. Age-associated factors influencing the efficacy of various forms of aerosol therapy. J. Aerosol. Med. 15(3), 343–345 (2002).

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