Deposition pattern of radiolabeled salbutamol inhaled from a metered-dose inhaler by means of a spacer with mask in young children with airway obstruction☆,☆☆,★
Section snippets
Patients
Fifteen children (13 boys) were studied at a mean age of 20.9 months (range, 2.5 months to 5 years) and a mean weight of 9.3 kg (range, 3.2 to 15 kg). All had recurrent wheezing and cough. Asthma was diagnosed in seven children, cystic fibrosis in four, and bronchopulmonary dysplasia in four. All participants were tested during a routine follow-up visit to our pediatric pulmonary clinic, at which time they were in stable condition. All participants were treated regularly with inhaled β2
RESULTS
Individual results of percentage deposition in the lungs, oropharynx, and stomach are summarized in the Table. The mean percentage deposition of the labeled salbutamol was 1.97% ± 1.4% in the lungs, 1.28% ± 0.77% in the oropharynx, and 1.11% ± 2.4% in the stomach.
The Figure shows examples of lung scan of two of the participants, 1 minute after labeled salbutamol was inhaled from an MDI via an Aerochamber with mask. The deposition of the inhaled spray is widespread, involving central and
DISCUSSION
Recurrent wheezing and chronic cough are common symptoms of airway obstruction in early childhood. Treatment with inhaled β2-agonists and topical corticosteroids is now widely accepted as a therapeutic strategy for children.4 The MDI has become the most widely used aerosol generator for older children who are capable of using the MDI properly, whereas the traditional jet nebulizer has remained the mainstay of aerosol administration to infants and young children. However, compliance with the jet
Acknowledgements
We thank Rami Huri and Andrea Vosolov for their invaluable technical assistance in the preparation of the labeled inhalers. David Albin, PhD, is from Agis Industries, Yeruham, Israel. We also thank Ami Sperber, MD, for his help with the manuscript.
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From the Department of Pediatrics and the Institute of Nuclear Medicine, Soroka Medical Center of Kupat Holim and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Reprint requests: Asher Tal, MD, Pediatric Department B, Soroka Medical Center, PO Box 151, Beer-Sheva 84101, Israel.
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0022-3476/96/$5.00 + 0 9/20/71669