Evaluation of a system for the delivery of inhaled beclomethasone dipropionate to intubated neonates.
Since systemic dexamethasone therapy for bronchopulmonary dysplasia is associated with numerous side effects, a simple system to deliver aerosolized beclomethasone dipropionate (BDP) directly to the lungs of intubated neonates was developed and evaluated in vitro. The system consists of a self-inflating bag, metered dose inhaler (MDI) adapter, Tygon spacer and endotracheal tube (ETT). A dose is delivered by discharging the MDI into the system and giving 3 'breaths' with the bag. Different sizes of ETT do not affect the drug output (1.17 +/- 0.29 vs. 1.32 +/- 0.34 micrograms of BDP per dose using a 3.0-mm or 3.5-mm ETT, respectively; means +/- SD). However, a shorter system spacer substantially reduces the drug output. The majority (54.0%) of the particles exiting the ETT and available to the patient are in the respirable range (0.5-5.5 microns). Based on adult doses and delivery of BDP and the relative sizes of the adult and neonatal lung, it is estimated that a neonate will require 1-6 doses/day. Replacing dexamethasone in the treatment of bronchopulmonary dysplasia with aerosol topical steroids delivered by this system may improve both the safety and efficacy.
Department of Pediatrics, Medical College of Virginia, Richmond.
H J
HJ
Rozycki
P R
PR
Bryon
K
K
Dailey
G R
GR
Gutcher
D000336:Aerosols; D001507:Beclomethasone / Q000008:administration & dosage*; D001997:Bronchopulmonary Dysplasia / Q000188:drug therapy*; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D006801:Humans; D007231:Infant, Newborn; D010316:Particle Size
D000336:Aerosols; D001507:Beclomethasone