title: Aerosol delivery in respiratory syncytial virus bronchiolitis: hood or face mask?
abstract: 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.
authors.affiliation: Department of Pediatrics, Sieff Government Hospital, Safed, Israel.
authors.forename: Israel
authors.initials: I
authors.lastname: Amirav
authors.forename: Anat
authors.initials: A
authors.lastname: Oron
authors.forename: Guy
authors.initials: G
authors.lastname: Tal
authors.forename: Karine
authors.initials: K
authors.lastname: Cesar
authors.forename: Ami
authors.initials: A
authors.lastname: Ballin
authors.forename: Sion
authors.initials: S
authors.lastname: Houri
authors.forename: Larisa
authors.initials: L
authors.lastname: Naugolny
authors.forename: Avigdor
authors.initials: A
authors.lastname: Mandelberg
mesh_terms: 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
chemical_list: D000336:Aerosols; D001993:Bronchodilator Agents