Aerosol delivery of nebulised budesonide in young children with asthma
Summary Background Lung deposition of inhaled steroids, likely to be of benefit in the anti-inflammatory treatment of asthma in young children, is low. This is explained by age specific anatomical and physiological characteristics as well as poor cooperation with aerosol therapy. However, total lung...
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| Veröffentlicht in: | Respiratory medicine 2009-11, Vol.103 (11), p.1738-1745 |
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| creator | Schueepp, Karen G Devadason, Sunalene G Roller, Christina Minocchieri, Stefan Moeller, Alexander Hamacher, Jürg Wildhaber, Johannes H |
| description | Summary Background Lung deposition of inhaled steroids, likely to be of benefit in the anti-inflammatory treatment of asthma in young children, is low. This is explained by age specific anatomical and physiological characteristics as well as poor cooperation with aerosol therapy. However, total lung deposition and the ratio of lung deposition to oropharyngeal deposition are key determinants of clinical efficacy and of systemic side effects of aerosolized drugs. Objectives The aim of this study was to determine lung deposition and ratio of lung deposition to oropharyngeal deposition using a modified vibrating membrane nebuliser to deliver budesonide with a small particle size, taking into account the needs of young children. Patients and methods Ten asthmatic children (5 males), mean age 20.3 months (range 6–41 months) inhaled radiolabelled budesonide (MMD 2.6 μm) through a modified vibrating membrane nebuliser (modified PARI e-Flow® ). Lung deposition expressed as a percentage of the emitted dose was measured using scintigraphy and the ratio of lung deposition to oropharyngeal deposition was calculated. Results Mean lung deposition (SD) expressed as percentage of emitted dose and mean lung to oropharyngeal deposition ratio (SD) in quietly breathing children ( n = 5) and in children crying during inhalation were 48.6% (10.5) versus 20.0% (10.9), and 1.0 (0.3) versus 0.3 (0.2), respectively. Conclusions We have shown that by using an improved age-adjusted complementary combination of delivery device and drug formulation to deliver small particles, lung deposition and ratio of lung deposition to oropharyngeal deposition in young asthmatic children is highly improved. But the main factor limiting aerosol delivery in this age group remains cooperation. |
| doi_str_mv | 10.1016/j.rmed.2009.04.029 |
| format | Article |
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This is explained by age specific anatomical and physiological characteristics as well as poor cooperation with aerosol therapy. However, total lung deposition and the ratio of lung deposition to oropharyngeal deposition are key determinants of clinical efficacy and of systemic side effects of aerosolized drugs. Objectives The aim of this study was to determine lung deposition and ratio of lung deposition to oropharyngeal deposition using a modified vibrating membrane nebuliser to deliver budesonide with a small particle size, taking into account the needs of young children. Patients and methods Ten asthmatic children (5 males), mean age 20.3 months (range 6–41 months) inhaled radiolabelled budesonide (MMD 2.6 μm) through a modified vibrating membrane nebuliser (modified PARI e-Flow® ). Lung deposition expressed as a percentage of the emitted dose was measured using scintigraphy and the ratio of lung deposition to oropharyngeal deposition was calculated. Results Mean lung deposition (SD) expressed as percentage of emitted dose and mean lung to oropharyngeal deposition ratio (SD) in quietly breathing children ( n = 5) and in children crying during inhalation were 48.6% (10.5) versus 20.0% (10.9), and 1.0 (0.3) versus 0.3 (0.2), respectively. Conclusions We have shown that by using an improved age-adjusted complementary combination of delivery device and drug formulation to deliver small particles, lung deposition and ratio of lung deposition to oropharyngeal deposition in young asthmatic children is highly improved. But the main factor limiting aerosol delivery in this age group remains cooperation.</description><identifier>ISSN: 0954-6111</identifier><identifier>EISSN: 1532-3064</identifier><identifier>DOI: 10.1016/j.rmed.2009.04.029</identifier><identifier>PMID: 19540100</identifier><language>eng</language><publisher>Kidlington: Elsevier Ltd</publisher><subject>Administration, Inhalation ; Aerosols ; Age Factors ; Asthma ; Asthma - diagnostic imaging ; Asthma - drug therapy ; Atoms & subatomic particles ; Biological and medical sciences ; Bronchodilator Agents - administration & dosage ; Bronchodilator Agents - analysis ; Budesonide - administration & dosage ; Budesonide - analysis ; Child, Preschool ; Childhood asthma ; Children & youth ; Chronic obstructive pulmonary disease, asthma ; Delivery. Postpartum. Lactation ; Drug dosages ; Efficiency ; Female ; Gynecology. Andrology. Obstetrics ; Humans ; Infant ; Infants ; Inhalation therapy ; Lung - chemistry ; Lung - diagnostic imaging ; Lungs ; Male ; Medical sciences ; Nebuliser ; Nebulizers and Vaporizers ; Oropharynx - chemistry ; Oropharynx - diagnostic imaging ; Particle Size ; Pneumology ; Pulmonary/Respiratory ; Radiolabelled aerosols ; Radionuclide Imaging ; Studies ; Treatment Outcome</subject><ispartof>Respiratory medicine, 2009-11, Vol.103 (11), p.1738-1745</ispartof><rights>Elsevier Ltd</rights><rights>2009 Elsevier Ltd</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c512t-5f4117eb9e7c31b9cf275b426ccd0a8f720d6b618f2466a38461aa4c408e7c123</citedby><cites>FETCH-LOGICAL-c512t-5f4117eb9e7c31b9cf275b426ccd0a8f720d6b618f2466a38461aa4c408e7c123</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.rmed.2009.04.029$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22044382$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19540100$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schueepp, Karen G</creatorcontrib><creatorcontrib>Devadason, Sunalene G</creatorcontrib><creatorcontrib>Roller, Christina</creatorcontrib><creatorcontrib>Minocchieri, Stefan</creatorcontrib><creatorcontrib>Moeller, Alexander</creatorcontrib><creatorcontrib>Hamacher, Jürg</creatorcontrib><creatorcontrib>Wildhaber, Johannes H</creatorcontrib><title>Aerosol delivery of nebulised budesonide in young children with asthma</title><title>Respiratory medicine</title><addtitle>Respir Med</addtitle><description>Summary Background Lung deposition of inhaled steroids, likely to be of benefit in the anti-inflammatory treatment of asthma in young children, is low. This is explained by age specific anatomical and physiological characteristics as well as poor cooperation with aerosol therapy. However, total lung deposition and the ratio of lung deposition to oropharyngeal deposition are key determinants of clinical efficacy and of systemic side effects of aerosolized drugs. Objectives The aim of this study was to determine lung deposition and ratio of lung deposition to oropharyngeal deposition using a modified vibrating membrane nebuliser to deliver budesonide with a small particle size, taking into account the needs of young children. Patients and methods Ten asthmatic children (5 males), mean age 20.3 months (range 6–41 months) inhaled radiolabelled budesonide (MMD 2.6 μm) through a modified vibrating membrane nebuliser (modified PARI e-Flow® ). Lung deposition expressed as a percentage of the emitted dose was measured using scintigraphy and the ratio of lung deposition to oropharyngeal deposition was calculated. Results Mean lung deposition (SD) expressed as percentage of emitted dose and mean lung to oropharyngeal deposition ratio (SD) in quietly breathing children ( n = 5) and in children crying during inhalation were 48.6% (10.5) versus 20.0% (10.9), and 1.0 (0.3) versus 0.3 (0.2), respectively. Conclusions We have shown that by using an improved age-adjusted complementary combination of delivery device and drug formulation to deliver small particles, lung deposition and ratio of lung deposition to oropharyngeal deposition in young asthmatic children is highly improved. But the main factor limiting aerosol delivery in this age group remains cooperation.</description><subject>Administration, Inhalation</subject><subject>Aerosols</subject><subject>Age Factors</subject><subject>Asthma</subject><subject>Asthma - diagnostic imaging</subject><subject>Asthma - drug therapy</subject><subject>Atoms & subatomic particles</subject><subject>Biological and medical sciences</subject><subject>Bronchodilator Agents - administration & dosage</subject><subject>Bronchodilator Agents - analysis</subject><subject>Budesonide - administration & dosage</subject><subject>Budesonide - analysis</subject><subject>Child, Preschool</subject><subject>Childhood asthma</subject><subject>Children & youth</subject><subject>Chronic obstructive pulmonary disease, asthma</subject><subject>Delivery. Postpartum. Lactation</subject><subject>Drug dosages</subject><subject>Efficiency</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Infant</subject><subject>Infants</subject><subject>Inhalation therapy</subject><subject>Lung - chemistry</subject><subject>Lung - diagnostic imaging</subject><subject>Lungs</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Nebuliser</subject><subject>Nebulizers and Vaporizers</subject><subject>Oropharynx - chemistry</subject><subject>Oropharynx - diagnostic imaging</subject><subject>Particle Size</subject><subject>Pneumology</subject><subject>Pulmonary/Respiratory</subject><subject>Radiolabelled aerosols</subject><subject>Radionuclide Imaging</subject><subject>Studies</subject><subject>Treatment Outcome</subject><issn>0954-6111</issn><issn>1532-3064</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kkGL1TAQx4Mo7tvVL-BBCiJ7ap2k07QFEZbFVWHBg3oOaTL15dmXrEm78r69Ke-xwh485TC__2TmxzD2ikPFgct3uyruyVYCoK8AKxD9E7bhTS3KGiQ-ZRvoGywl5_yMnae0gwwiwnN2xnMBOMCG3VxRDClMhaXJ3VM8FGEsPA3L5BLZYlgspeCdpcL54hAW_7MwWzfZSL744-ZtodO83esX7Nmop0QvT-8F-3Hz8fv15_L266cv11e3pWm4mMtmRM5bGnpqTc2H3oyibQYU0hgLuhtbAVYOknejQCl13aHkWqNB6HKCi_qCXR773sXwe6E0q71LhqZJewpLUm2N0GKHTSbfPCJ3YYk-D6c41HkaxHalxJEy2UKKNKq76PY6HjKkVslqp1bJapWsAFWWnEOvT62XYa09RE5WM_D2BOhk9DRG7Y1LD5wQgFh36zbvjxxlZfeOokrGkTdkXSQzKxvc_-f48ChuJudd_vEXHSj921cloUB9W89hvQboAXjDZf0XpwCtsw</recordid><startdate>20091101</startdate><enddate>20091101</enddate><creator>Schueepp, Karen G</creator><creator>Devadason, Sunalene G</creator><creator>Roller, Christina</creator><creator>Minocchieri, Stefan</creator><creator>Moeller, Alexander</creator><creator>Hamacher, Jürg</creator><creator>Wildhaber, Johannes H</creator><general>Elsevier Ltd</general><general>Elsevier</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>ASE</scope><scope>FPQ</scope><scope>H94</scope><scope>K6X</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20091101</creationdate><title>Aerosol delivery of nebulised budesonide in young children with asthma</title><author>Schueepp, Karen G ; Devadason, Sunalene G ; Roller, Christina ; Minocchieri, Stefan ; Moeller, Alexander ; Hamacher, Jürg ; Wildhaber, Johannes H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c512t-5f4117eb9e7c31b9cf275b426ccd0a8f720d6b618f2466a38461aa4c408e7c123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Administration, Inhalation</topic><topic>Aerosols</topic><topic>Age Factors</topic><topic>Asthma</topic><topic>Asthma - diagnostic imaging</topic><topic>Asthma - drug therapy</topic><topic>Atoms & subatomic particles</topic><topic>Biological and medical sciences</topic><topic>Bronchodilator Agents - administration & dosage</topic><topic>Bronchodilator Agents - analysis</topic><topic>Budesonide - administration & dosage</topic><topic>Budesonide - analysis</topic><topic>Child, Preschool</topic><topic>Childhood asthma</topic><topic>Children & youth</topic><topic>Chronic obstructive pulmonary disease, asthma</topic><topic>Delivery. Postpartum. Lactation</topic><topic>Drug dosages</topic><topic>Efficiency</topic><topic>Female</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Infant</topic><topic>Infants</topic><topic>Inhalation therapy</topic><topic>Lung - chemistry</topic><topic>Lung - diagnostic imaging</topic><topic>Lungs</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Nebuliser</topic><topic>Nebulizers and Vaporizers</topic><topic>Oropharynx - chemistry</topic><topic>Oropharynx - diagnostic imaging</topic><topic>Particle Size</topic><topic>Pneumology</topic><topic>Pulmonary/Respiratory</topic><topic>Radiolabelled aerosols</topic><topic>Radionuclide Imaging</topic><topic>Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schueepp, Karen G</creatorcontrib><creatorcontrib>Devadason, Sunalene G</creatorcontrib><creatorcontrib>Roller, Christina</creatorcontrib><creatorcontrib>Minocchieri, Stefan</creatorcontrib><creatorcontrib>Moeller, Alexander</creatorcontrib><creatorcontrib>Hamacher, Jürg</creatorcontrib><creatorcontrib>Wildhaber, Johannes H</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Respiratory medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schueepp, Karen G</au><au>Devadason, Sunalene G</au><au>Roller, Christina</au><au>Minocchieri, Stefan</au><au>Moeller, Alexander</au><au>Hamacher, Jürg</au><au>Wildhaber, Johannes H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Aerosol delivery of nebulised budesonide in young children with asthma</atitle><jtitle>Respiratory medicine</jtitle><addtitle>Respir Med</addtitle><date>2009-11-01</date><risdate>2009</risdate><volume>103</volume><issue>11</issue><spage>1738</spage><epage>1745</epage><pages>1738-1745</pages><issn>0954-6111</issn><eissn>1532-3064</eissn><abstract>Summary Background Lung deposition of inhaled steroids, likely to be of benefit in the anti-inflammatory treatment of asthma in young children, is low. This is explained by age specific anatomical and physiological characteristics as well as poor cooperation with aerosol therapy. However, total lung deposition and the ratio of lung deposition to oropharyngeal deposition are key determinants of clinical efficacy and of systemic side effects of aerosolized drugs. Objectives The aim of this study was to determine lung deposition and ratio of lung deposition to oropharyngeal deposition using a modified vibrating membrane nebuliser to deliver budesonide with a small particle size, taking into account the needs of young children. Patients and methods Ten asthmatic children (5 males), mean age 20.3 months (range 6–41 months) inhaled radiolabelled budesonide (MMD 2.6 μm) through a modified vibrating membrane nebuliser (modified PARI e-Flow® ). Lung deposition expressed as a percentage of the emitted dose was measured using scintigraphy and the ratio of lung deposition to oropharyngeal deposition was calculated. Results Mean lung deposition (SD) expressed as percentage of emitted dose and mean lung to oropharyngeal deposition ratio (SD) in quietly breathing children ( n = 5) and in children crying during inhalation were 48.6% (10.5) versus 20.0% (10.9), and 1.0 (0.3) versus 0.3 (0.2), respectively. Conclusions We have shown that by using an improved age-adjusted complementary combination of delivery device and drug formulation to deliver small particles, lung deposition and ratio of lung deposition to oropharyngeal deposition in young asthmatic children is highly improved. But the main factor limiting aerosol delivery in this age group remains cooperation.</abstract><cop>Kidlington</cop><pub>Elsevier Ltd</pub><pmid>19540100</pmid><doi>10.1016/j.rmed.2009.04.029</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Administration, Inhalation Aerosols Age Factors Asthma Asthma - diagnostic imaging Asthma - drug therapy Atoms & subatomic particles Biological and medical sciences Bronchodilator Agents - administration & dosage Bronchodilator Agents - analysis Budesonide - administration & dosage Budesonide - analysis Child, Preschool Childhood asthma Children & youth Chronic obstructive pulmonary disease, asthma Delivery. Postpartum. Lactation Drug dosages Efficiency Female Gynecology. Andrology. Obstetrics Humans Infant Infants Inhalation therapy Lung - chemistry Lung - diagnostic imaging Lungs Male Medical sciences Nebuliser Nebulizers and Vaporizers Oropharynx - chemistry Oropharynx - diagnostic imaging Particle Size Pneumology Pulmonary/Respiratory Radiolabelled aerosols Radionuclide Imaging Studies Treatment Outcome |
| title | Aerosol delivery of nebulised budesonide in young children with asthma |
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