EFFICIENCY OF AEROSOL MEDICATION DELIVERY FROM A METERED-DOSE INHALERVERSUS JET NEBULIZER IN INFANTS WITH BRONCHOPULMONARY DYSPLASIA

The best means for optimal delivery of drugs into lungs of infants wit h bronchopulmonary dysplasia (BPD) is uncertain. We aimed to measure r adio-aerosol deposition of salbutamol by jet nebulizer and metered dos e inhalers (MDI) in ventilated and non-ventilated BPD infants. In a ra ndomized, crossover sequence, salbutamol lung deposition was measured using an MDI (2 puffs or 200 mu g) or sidestream jet nebulizer (5 minu tes of nebulization with 100 mu g/kg) in 10 ventilated (mean birthweig ht, 1,101 g) and 13 non-ventilated (mean birthweight, 1,093 g) prematu rely born infants. Non-ventilated infants inhaled aerosol through a fa ce mask, connected to a nebulizer or an MDI and spacer (Aerochamber(R) ). Ventilated infants received aerosol from an MDI + MV15 Aerochamber( R) or a nebulizer inserted in the ventilator circuit. Lung deposition by both methods was low: mean (SEM) from the MDI was 0.67 (0.17)% of t he actuated dose, and from the nebulizer it was 1.74 (0.21)% and 0.28 (0.04)% of the nebulized and initial reservoir doses, respectively. Co rresponding figures for the ventilated infants were 0.98 (0.19)% from the MDI and 0.95 (0.23)% and 0.22 (0.08)% from the nebulizer. In both groups, and for both methods of delivery, there was marked inter-subje ct variability in lung deposition and a tendency for the aerosol to be distributed to the central lung regions. (C) 1996 Wiley-Liss, Inc.