PT - JOURNAL ARTICLE AU - Ariel Berlinski TI - Effect of mask dead space and occlusion of mask holes on delivery of nebulized albuterol AID - 10.4187/respcare.02978 DP - 2013 Dec 10 TA - Respiratory Care PG - respcare.02978 4099 - http://rc.rcjournal.com/content/early/2013/12/03/respcare.02978.short 4100 - http://rc.rcjournal.com/content/early/2013/12/03/respcare.02978.full AB - Background Infants and children with respiratory conditions are often prescribed bronchodilators. Face masks are used to facilitate the administration of nebulized therapy in patients unable to use a mouthpiece. Masks incorporate holes to their design and their occlusion during aerosol delivery has been a common practice. Masks are available in different sizes and different dead volumes. The aim of this study was to compare the effect of different degrees of occlusion of the mask holes and different mask dead space on the amount of nebulized albuterol available at the mouth opening in a model of a spontaneously breathing child. Methods A breathing simulator delivered infant (VT=50ml; breathing frequency=30/min; I:E=1:3), child (VT=155ml; breathing frequency=25/min; I:E=1:2 ) and adult (VT=500ml; breathing frequency=15/min; I:E=1:2) breathing patterns was connected to a collection filter hidden behind a face plate. A pediatric and an adult size mask connected to a continuous output jet nebulizer were sealed to the face plate. The nebulizers (n=3) were loaded with albuterol sulfate (2.5mg/3ml) and operated with 6 L/min of compressed air for 5 min. Experiments were repeated with different degrees of occlusion (0%, 50%, and 90%). Albuterol was extracted from the filter and measured with a spectrophotometer at 276 nm. Results: The occlusion of the holes of the large mask did not increase the amount of albuterol in any of the breathing patterns. The amount of albuterol captured at the mouth opening did not change when the small mask was switched to the large mask except with the breathing pattern of a child and the holes of the mask were 50% occluded (p = .02). Conclusions Neither decreasing the dead space of the mask nor occluding the mask holes increased the amount of nebulized albuterol captured at the mouth opening.