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.
Wildhaber
J H
JH
The Perth Medical Aerosol Research Group, the Department of Respiratory Medicine, Princess Margaret Hospital for Children, Perth, Australia.
Dore
N D
ND
Wilson
J M
JM
Devadason
S G
SG
LeSouëf
P N
PN
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