Improving the Efficiency of Inhalation Therapy in Young Children

Inhalation therapy is the customary method to deliver medication to patients with lung disease. It is very difficult to deliver aerosolized drugs to the lungs efficiently and in a reproducible manner, especially in young children. Chapter 1 of this thesis deals with the background of inhalation therapy. In chapter 2, we studied the effects of size and position of facemask leaks on spacer output and lung dose in-vitro. We found that even a small air leak in the facemask can drastically reduce spacer output and lung dose. Chapter 3 presents a daily life study in which we tested three commercially available facemasks in young children. We found that a round-shaped facemask gave significantly higher filter doses compared with face-shaped masks. In Chapter 4, we evaluated patterns of aerosol loss from various facemasks combined with a nebulizer. The mask with large open vents showed the highest total aerosol loss and greater exposure of the children’s eyes and skin to aerosol compared with the other tested masks. Chapter 5 presents a study in which we evaluated the feasibility of drug administration by means of pMDI-spacer in sleeping young children. During most sleep administrations the children woke up and became distressed. In addition, the dose inhaled when the child was asleep was significantly lower than when awake. In Chapter 6 the pulmonary bio-availability for inhaled beclomethasone dipropionate (BDP) aerosols of different particle sizes was investigated in adults with mild asthma. We found that the systemic availability for monodisperse BDP aerosols with a MMAD of 1.5 μm was 2-3 fold lower than for aerosols with MMADs of 2.5 and 4.5 μm.

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