title: Delivery of therapeutic aerosols to intubated babies.
abstract: Delivery of drug aerosols to the lungs of ventilated neonates by metered dose inhaler and spacer (Aerochamber) and ultrasonic nebuliser (Pentasonic) was assessed using sodium cromoglycate. The mean proportion of a known intratracheal dose of sodium cromoglycate excreted in the urine of four intubated infants was 37.5%. After assuming that 38% of the sodium cromoglycate aerosol reaching the neonatal lung will be excreted in the urine, three puffs (15 mg) delivered by metered dose inhaler and spacer resulted in a pulmonary dose of 258 micrograms (1.7%, n = 7). A dose of 20 mg (4 ml) sodium cromoglycate ultrasonically nebulised over five minutes into the inspiratory limb of a standard ventilator circuit produced a pulmonary dose of 257 micrograms (1.3%, n = 7). Of two in vitro lung models assessed, a combination of filter and neonatal test lung was superior to a multistage impactor in estimating the in vivo pulmonary sodium cromoglycate dose delivered by metered dose inhaler and spacer (243 micrograms v 1740 micrograms).
authors.affiliation: Department of Paediatrics and Neonatal Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London.
authors.forename: J
authors.initials: J
authors.lastname: Grigg
authors.forename: S
authors.initials: S
authors.lastname: Arnon
authors.forename: T
authors.initials: T
authors.lastname: Jones
authors.forename: A
authors.initials: A
authors.lastname: Clarke
authors.forename: M
authors.initials: M
authors.lastname: Silverman
mesh_terms: D000336:Aerosols; D004205:Cromolyn Sodium / Q000008:administration & dosage* / Q000032:analysis; D005069:Evaluation Studies as Topic; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000188:drug therapy*; D007385:Intermittent Positive-Pressure Ventilation / Q000379:methods*; D008168:Lung / Q000737:chemistry; D008954:Models, Biological; D009330:Nebulizers and Vaporizers; D014132:Trachea / Q000737:chemistry
chemical_list: D000336:Aerosols; D004205:Cromolyn Sodium