title: Lung function response to bronchodilator nebulization via hood in wheezy infants: a pilot study.
abstract: BACKGROUND
  In infants, small volume nebulizers with a face mask are commonly used to facilitate aerosol therapy. However, infants may be disturbed by mask application, causing poor mask-to-face seal and thus reducing the dose delivered.
  
  
  OBJECTIVE
  To compare lung function response to bronchodilator nebulization via two delivery devices: hood versus mask.
  
  
  METHODS
  We studied 26 recurrently wheezy infants aged 45.8 weeks (95% confidence interval 39.6-52.0). Inhalations of 0.30 mg/kg salbutamol were administered in two alliqots 30 minutes apart using mask and hood in alternating order (M+H or H+M). Response to inhalations was measured by maximal expiratory flows at functional residual capacity (V'maxFRC) at 5 minute intervals after each dose, and area under the V'maxFRC curve (AUC) was documented.
  
  
  RESULTS
  A small but significant response to salbutamol was observed following the second inhalation with V'maxFRC, improving by 31.7% (7.2-56.2, P (0.02) and AUC by 425% x min (-154, 1004; P < 0.02). The improvement following salbutamol was similar by both delivery modalities but with a small but significantly better response when H was used after M (P < 0.01).
  
  
  CONCLUSIONS
  Nebulized salbutamol induced a variable but positive response in wheezy infants. Salbutamol via hood was as effective as conventional face mask delivery. Since it is simple and patient-friendly, it could replace the face mask method particularly with uncooperative infants.
authors: Institute of Pulmonology, Hadassah University Hospital and Hebrew University-Hadassah Medical School, Jerusalem, Israel. ephraimby@gmail.com
authors: Ephraim
authors: E
authors: Bar-Yishay
authors: Avraham
authors: A
authors: Avital
authors: Chaim
authors: C
authors: Springer
authors: Israel
authors: I
authors: Amirav
mesh_terms: D000280:Administration, Inhalation; D000420:Albuterol / Q000008:administration & dosage* / Q000493:pharmacokinetics; D019540:Area Under Curve; D001249:Asthma / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology*; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D005260:Female; D005652:Functional Residual Capacity; D006801:Humans; D007223:Infant; D008297:Male; D008397:Masks; D008448:Maximal Expiratory Flow Rate; D009330:Nebulizers and Vaporizers; D010865:Pilot Projects
chemical_list: D001993:Bronchodilator Agents; D000420:Albuterol