Inhalation therapy in asthma: nebulizer or pressurized metered-dose inhaler with holding chamber? In vivo comparison of lung deposition in children.
OBJECTIVE
To compare lung deposition from a nebulizer and a pressurized metered-dose inhaler (pMDI)/holding chamber to determine their efficiency in aerosol delivery to children.


METHODS
Children with stable asthma (n = 17) aged 2 to 9 years inhaled in random order radiolabeled salbutamol from a nebulizer and a pMDI through a nonstatic holding chamber. Body and lung deposition of radiolabeled salbutamol was assessed with a gamma camera.


RESULTS
Mean (absolute dose) total lung deposition expressed as a percentage of the nebulized dose was 5.4% (108 microg) in younger children (<4 years) and 11.1% (222 microg) in older children (>4 years). Mean (absolute dose) total lung deposition expressed as a percentage of the metered dose was 5.4% (21.6 microg) in younger and 9.6% (38.4 microg) in older children.


CONCLUSIONS
For the same age groups we have shown equivalent percentages of total lung deposition of radiolabeled salbutamol aerosolized by either a nebulizer or a pMDI/holding chamber. However, the delivery rate per minute and the total dose of salbutamol deposited were significantly higher for the nebulizer.
The Perth Medical Aerosol Research Group, the Department of Respiratory Medicine, Princess Margaret Hospital for Children, Perth, Australia.
J H
JH
Wildhaber
N D
ND
Dore
J M
JM
Wilson
S G
SG
Devadason
P N
PN
LeSouëf
D000420:Albuterol / Q000008:administration & dosage*; D000704:Analysis of Variance; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008168:Lung / Q000737:chemistry*; D009330:Nebulizers and Vaporizers; D011877:Radionuclide Imaging
D001993:Bronchodilator Agents; D000420:Albuterol