A novel, versatile valved holding chamber for delivering inhaled medications to neonates and small children: Laboratory simulation of delivery options

Respiratory Care

Volumn 55, Issue 4, 2010, Pages 419-426

  DiBlasi, Robert M ^a,b   Coppolo, Dominic P ^c   Nagel, Mark W ^d   Doyle, Cathy C ^d   Avvakoumova, Valentina I ^d   Ali, Rubina S ^d   Mitchell, Jolyon P ^d  

^a SEATTLE CHILDREN S RESEARCH INSTITUTE   (United States)

^b SEATTLE CHILDREN S HOSPITAL   (United States)

^c Monaghan Medical   (United States)

^d TRUDELL MEDICAL INTERNATIONAL   (Canada)

Author keywords

Aerosol; Inhaler; Manual resuscitation; Mechanical ventilation; Neonate; Simulation; Small child; Spontaneous breathing

Indexed keywords

FLUORINATED HYDROCARBON; SALBUTAMOL; BRONCHODILATING AGENT;

AEROSOL; AMBIENT AIR; ANALYSIS OF VARIANCE; ARTICLE; ARTIFICIAL VENTILATION; BREATHING; CHILD; CONTROLLED STUDY; DEVICE; DRUG DELIVERY SYSTEM; ENDOTRACHEAL TUBE; FACE MASK; HUMAN; HUMIDITY; METERED DOSE INHALER; NEWBORN; PREMATURITY; PRESCHOOL CHILD; QUANTITATIVE ANALYSIS; RESUSCITATION; SIMULATION; VALVED HOLDING CHAMBER; BIOLOGICAL MODEL; CHRONIC OBSTRUCTIVE LUNG DISEASE; COMPARATIVE STUDY; ENDOTRACHEAL INTUBATION; EQUIPMENT DESIGN; INFANT; INHALATIONAL DRUG ADMINISTRATION; MASK; NEBULIZER; REPRODUCIBILITY;

ADMINISTRATION, INHALATION; AEROSOLS; ALBUTEROL; BRONCHODILATOR AGENTS; CHILD, PRESCHOOL; EQUIPMENT DESIGN; HUMANS; INFANT; INFANT, NEWBORN; INFANT, PREMATURE; INTUBATION, INTRATRACHEAL; LUNG DISEASES, OBSTRUCTIVE; MASKS; MODELS, BIOLOGICAL; NEBULIZERS AND VAPORIZERS; REPRODUCIBILITY OF RESULTS; RESPIRATION, ARTIFICIAL;

EID: 77954898020     PISSN: 00201324     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (28)

1. Hintz S. Pharmacology review: bronchodilator therapy in the pre-term infant. Neo Reviews 2003;4(9):e245-e249.
2. American Association for Respiratory Care. AARC Clinical Practice Guideline. Selection of an aerosol delivery device for neonatal and pediatric patients. Respir Care 1995;40(12):1325-135.
3. Ferguson C, Gidwani S. Delivery of bronchodilators in acute asthma in children. Emerg Med. J 2006;23(6):471-472.
4. Stocks J, Hislop AA. Structure and function of the respiratory system. In: Bisgaard H, O'Callaghan C, Smaldone GC, editors. Drug delivery to the lung. New York: Marcel Dekker; 2002:47-104.
5. Fink J. Aerosol delivery to ventilated infant and pediatric patients. Respir Care 2004;49(6):653-665.
6. Silverman M. Aerosol therapy in the newborn. Arch Dis Child 1990; 65(8):906-908.
7. Schleufe P, Reiffen HP, Piepenbrock S. Effective application of bronchodilator aerosols from metered-dose inhalers (MDI) via re-suscitator-bag and adapter. Resuscitation 1998;39(3):175-178.
8. Fink J, Dhand R. Bronchodilator resuscitation in the emergency department. Part 1 of 2: device selection. Respir Care 1999;44(11): 1353-1374.
9. Waugh JB, Deshpande VM, Hardwood RJ. Rapid interpretation of ventilator waveforms. Upper Saddle River, New Jersey: Prentice Hall; 1999.
10. Bhutani VK, Sivieri EM. Pulmonary function and graphics. In: Goldsmith JP, Karotkin EH, editors. Assisted ventilation of the neonate. Philadelphia: WB Saunders; 2004:293-310.
11. Lough MD. Pulmonary function. In: Chatburn RL, Lough MD, editors. Handbook of respiratory care. Chicago: Year Book Medical Publishers; 1990:41-57.
12. Mitchell JP, Wiersema KJ, MacKay HA, Nagel MW, Pischel SM, Cripps AL. Novel approach for evaluating medication delivered via valved holding chambers (VHCs) with facemask using a face model for infants and small children. In: Dalby RN, Byron PR, Peart J, Suman JD, Farr SJ, Young PM, editors. Respiratory drug delivery. River Grove, IL: Davis Healthcare International; 2008:785-788.
13. Cripps AL, Davis AM, Pischel SM, Wiersema KJ, Nagel MW, Mitchell JP. In-vitro performance of albuterol hfa formulation in two valved holding chambers at low inspiratory flow rates and extended delay times (abstract). J Allergy Clin Immunol 2008;121(2 Suppl 1):S9.
14. Cole CH, Mitchell JP, Foley MP, Nagel MW. Hydrofluoroalkane-versus chlorofluorocarbon-beclomethasone delivery in neonatal models. Arch Dis Child Fetal Neonat Edn 2004;89(5):F417-F418.
15. Tal A, Golan H, Grauer N, Aviram M, Albin D, Quastel MR. 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 1996;128(4):479-484.
16. Glaxo Smith Kline. Ventolin-HFA: prescribing information. Research Triangle Park, NC; 2008. http://us.gsk.com/products/assets/us_ven tolin_hfa.pdf. Accessed February 3, 2010.
17. Fink JB, Dhand R, Grychowski J, Fahey PJ, Tobin MJ. Am Reconciling in-vitro and in-vivo measurements of aerosol delivery from a me-tered-dose inhaler during mechanical ventilation, and defining effi-ciency enhancing factors. J Respir Crit Care Med 1999(1);159: 63-68.
18. Dhand R, Tobin MJ. Inhaled bronchodilator therapy in mechanically ventilated patients. Am J Respir Crit Care Med 1997;156(1):3-10.
19. Miller DD, Amin MM, Palmer LB, Shah AR, Smaldone GC. Aerosol delivery and modern mechanical ventilation: in vitro/in vivo evaluation. Am J Respir Crit Care Med 2003;168(10):1205-1209.
20. Dhand R, Mercier E. Effective inhaled drug administration to mechanically ventilated patients. Expert Opin Drug Deliv 2007;4(1): 47-61.
21. Dhand R. Aerosol delivery during mechanical ventilation: from basic techniques to new devices. J Aerosol Med Pulmon Deliv 2008;21(1): 45-60.
22. Newman SP. Therapeutic aerosols 1. Physical and practical considerations. Thorax 1983;38(12):881-886.
23. Cole CH. Special problems in aerosol delivery: neonatal and pedi-atric considerations. Respir Care 2000;45(6):646-651.
24. Mitchell JP, Nagel MW. Cascade impactors for the size characterization of aerosols from medical inhalers: their uses and limitations. J Aerosol Med 2003;16(4):341-377.
25. Bonam M, Christopher D, Cipolla D, Donovan B, Goodwin D, Holmes S, et al. Minimizing variability of cascade impaction measurements in inhalers and nebulizers. AAPS Pharm SciTech 2008;9(2):404-413.
26. Bisgaard H. Delivery of inhaled medications in children. J Asthma 1997;34(6):443-467.
27. Esposito-Festen JE, Ates B, Van Vliet FLM, Verbraak AFM, de Jongste JC, Tiddens HA. Effect of a facemask leak on aerosol delivery from a pMDI-spacer system. J Aerosol Med 2004;17(1):1-6.
28. Shah SA, Berlinski A, Rubin BK. Force-dependent static dead space of face masks used with holding chambers. Respir Care 2006;51(2): 140-144.