Aerosol delivery in respiratory syncytial virus bronchiolitis: hood or face mask?
OBJECTIVE
To compare the utility of the hood versus the face mask for delivery of inhaled medications to infants hospitalized with viral bronchiolitis.


METHODS
Randomized, double-blinded, controlled trial; 49 hospitalized infants with viral bronchiolitis, age 2.75 +/- 2.2 months (mean +/- SD), were grouped to either the hood (n = 25) or the mask (n = 24). Each subject received inhalation treatments with the use of both devices. Half of the Hood Group received the active drug treatment (1.5 mg epinephrine in 4 mL saline [3%]) via hood followed immediately by placebo treatment (normal saline) via mask, whereas the other half received the opposite order. Half of the Mask Group received the active drug treatment via mask followed immediately by placebo treatment via hood, whereas the other half received the opposite order. Therapy was repeated 3 times daily until discharge. Outcome measures included clinical scores and parental preference.


RESULTS
Percent improvement in clinical severity scores after inhalation was significant in both groups on days 1, 2, and 3 after admission (Hood Group: 15%, 15.4%, and 16.4%, respectively; Mask Group: 17.5%, 12.1%, and 12.7%, respectively; P < .001). No significant difference in clinical scores improvement between groups was observed. Eighty percent (39/49) of parents favored the hood over the mask; 18% (9/49) preferred the mask and 2% (1/49) were indifferent.


CONCLUSIONS
In infants hospitalized with viral bronchiolitis and in whom aerosol treatment is considered, aerosol delivery by hood is as effective as by mask. However, according to parents, the tolerability of the hood is significantly better than that of a mask.
Amirav
Israel
I
Department of Pediatrics, Sieff Government Hospital, Safed, Israel.
Oron
Anat
A
Tal
Guy
G
Cesar
Karine
K
Ballin
Ami
A
Houri
Sion
S
Naugolny
Larisa
L
Mandelberg
Avigdor
A
D000336:Aerosols / Q000008:administration & dosage*; D001990:Bronchiolitis, Viral / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008397:Masks; D009330:Nebulizers and Vaporizers; D017060:Patient Satisfaction; D018357:Respiratory Syncytial Virus Infections / Q000188:drug therapy*; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
D000336:Aerosols; D001993:Bronchodilator Agents