Nebulization of drugs in a nasal CPAP system

Aerosolized drugs have been used in infants for the treatment of respirator y distress syndrome and bronchopulmonary dysplasia (beta-agonists, steroids and surfactant) and bronchiolitis due to respiratory syncytial virus (epin ephrine and ribavirin). Controlled clinical trials have, however, produced conflicting results, probably due in part to problems with the transportati on of the aerosol from the nebulizer to the bronchioli. We have modified a nasal continuous positive airway pressure (CPAP) system permitting an aeros ol to flow through a canal to the nasal prongs and into the airways of the infant. It has been used successfully for the administration of epinephrine , salbutamol, budesonide, acetylcysteine, natural surfactant and ribavirin to sick infants. The modified nasal CPAP system is a simple, safe, cost-eff icient and baby-friendly system for respiratory support and drug treatment, which can be used in future trials of aerosolized drugs.