Delivery of therapeutic aerosols to intubated babies.

J Grigg, S Arnon, T Jones, A Clarke, M Silverman

Department of Paediatrics and Neonatal Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London.

Delivery of drug aerosols to the lungs of ventilated neonates by metered dose inhaler and spacer (Aerochamber) and ultrasonic nebuliser (Pentasonic) was assessed using sodium cromoglycate. The mean proportion of a known intratracheal dose of sodium cromoglycate excreted in the urine of four intubated infants was 37.5%. After assuming that 38% of the sodium cromoglycate aerosol reaching the neonatal lung will be excreted in the urine, three puffs (15 mg) delivered by metered dose inhaler and spacer resulted in a pulmonary dose of 258 micrograms (1.7%, n = 7). A dose of 20 mg (4 ml) sodium cromoglycate ultrasonically nebulised over five minutes into the inspiratory limb of a standard ventilator circuit produced a pulmonary dose of 257 micrograms (1.3%, n = 7). Of two in vitro lung models assessed, a combination of filter and neonatal test lung was superior to a multistage impactor in estimating the in vivo pulmonary sodium cromoglycate dose delivered by metered dose inhaler and spacer (243 micrograms v 1740 micrograms).

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Aerosol drug delivery to intubated neonates.

H J Rozycki, P Byron, and G R Gutcher
Arch. Dis. Child. 1992 67: 885. [PDF]

This article has been cited by other articles:

• Kohler, E, Jilg, G, Avenarius, S, Jorch, G (2008). Lung deposition after inhalation with various nebulisers in preterm infants. Arch. Dis. Child. Fetal Neonatal Ed. 93: F275-F279 [Abstract] [Full Text]  
• Yeh, T. F., Lin, H. C., Chang, C. H., Wu, T. S., Su, B. H., Li, T. C., Pyati, S., Tsai, C. H. (2008). Early Intratracheal Instillation of Budesonide Using Surfactant as a Vehicle to Prevent Chronic Lung Disease in Preterm Infants: A Pilot Study. Pediatrics 121: e1310-e1318 [Abstract] [Full Text]  
• Hintz, S. R. (2003). Pharmacology Review: Bronchodilator Aerosol Therapy in the Preterm Infant. NeoReviews 4: e245-249 [Full Text]  
• Halliday, H. L., Patterson, C. C., Halahakoon, C. W. N. L., on Behalf of the European Multicenter Steroid Stud, (2001). A Multicenter, Randomized Open Study of Early Corticosteroid Treatment (OSECT) in Preterm Infants With Respiratory Illness: Comparison of Early and Late Treatment and of Dexamethasone and Inhaled Budesonide. Pediatrics 107: 232-240 [Abstract] [Full Text]  
• Cole, C. H., Colton, T., Shah, B. L., Abbasi, S., MacKinnon, B. L., Demissie, S., Frantz, I. D. (1999). Early Inhaled Glucocorticoid Therapy to Prevent Bronchopulmonary Dysplasia. NEJM 340: 1005-1010 [Abstract] [Full Text]  
• Fok, T F, Lam, K, Ng, P C, So, H K, Cheung, K L, Wong, W, So, K W (1998). Randomised crossover trial of salbutamol aerosol delivered by metered dose inhaler, jet nebuliser, and ultrasonic nebuliser in chronic lung disease. Arch. Dis. Child. Fetal Neonatal Ed. 79: 100F-104 [Abstract] [Full Text]  
• Fok, T. F., Al-Essa, M., Dolovich, M., Rasid, F., Kirpalani, H. (1998). Nebulisation of surfactants in an animal model of neonatal respiratory distress. Arch. Dis. Child. Fetal Neonatal Ed. 78: 3F-9 [Abstract] [Full Text]  
• VISCARDI, R. M., HASDAY, J. D., GUMPPER, K. F., TACIAK, V., CAMPBELL, A. B., PALMER, T. W. (1997). Cromolyn Sodium Prophylaxis Inhibits Pulmonary Proinflammatory Cytokines in Infants at High Risk for Bronchopulmonary Dysplasia. Am. J. Respir. Crit. Care Med. 156: 1523-1529 [Abstract] [Full Text]