Delivery of micronized budesonide suspension by metered dose inhaler and jet nebulizer into a neonatal ventilator circuit.
We compared the delivery of a micronized suspension of budesonide by a metered dose inhaler (MDI) with two different spacers (Aerochamber and Aerovent) and by two jet nebulizers (MAD2 and Ultravent) to a ventilated neonatal test-lung using a standard neonatal ventilator circuit. The combination of MDI and Aerochamber was significantly better at delivering budesonide to a filter in front of the test lung (14.2% of aerosolized dose) than were either the MDI and Aerovent (3.6%) or the Ultravent or MAD2 jet nebulizers (0.02% and 0.68% of initial reservoir dose). Of the droplets emerging from the MDI, Aerochamber, and ET tube, 18% of the initial dose was in droplets less than 4.7 microns. Assuming that the test-lung model accurately reflects in vivo deposition, the combination of MDI and Aerochamber appears to be an extremely effective way of delivering budesonide aerosol to ventilated newborn infants.
Arnon
S
S
Department of Paediatrics and Neonatal Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, England.
Grigg
J
J
Nikander
K
K
Silverman
M
M
D000336:Aerosols; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D019819:Budesonide; D006801:Humans; D007231:Infant, Newborn; D008954:Models, Biological; D009330:Nebulizers and Vaporizers; D011282:Pregnenediones / Q000008:administration & dosage*; D013535:Suspensions; D012122:Ventilators, Mechanical
D000336:Aerosols; D001993:Bronchodilator Agents; D011282:Pregnenediones; D013535:Suspensions; D019819:Budesonide