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Aerosol therapy: the special needs of young children

Hettie M Janssens1, Harm A W M Tiddens

  • 1Department of Paediatric Pulmonology, Erasmus MC-Sophia, University Medical Center Rotterdam, Sophia Children's Hospital, Rotterdam, The Netherlands. h.janssens@erasmusmc.nl

Paediatric Respiratory Reviews
|June 27, 2006
PubMed

Insights

Efficient aerosol delivery to young children requires specific devices and techniques. Optimal lung deposition depends on a good facemask seal, child cooperation, quiet breathing, and small aerosol particles.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Pharmaceutical Sciences

Background:

  • Aerosol therapy in young children presents unique challenges due to physiological and behavioral factors.
  • Children's inability to perform coordinated inhalation maneuvers and nasal breathing necessitates specialized administration techniques.

Purpose of the Study:

  • To review the challenges and optimal strategies for efficient aerosol delivery in pediatric patients.
  • To guide clinicians in selecting appropriate inhalation devices for young children with respiratory conditions.

Main Methods:

  • Review of current literature on aerosol therapy devices and techniques for pediatric use.
  • Analysis of factors influencing lung deposition, including device type, particle size, and patient cooperation.

Main Results:

  • Pressurized metered-dose inhalers (pMDIs) with spacers are recommended for maintenance asthma therapy in young children.
  • Facemask seal integrity and child cooperation are critical for effective drug delivery; crying significantly reduces lung dose.
  • Extra-fine particle aerosols and a good facemask seal can improve lung deposition.

Conclusions:

  • Optimal aerosol delivery in young children requires a combination of appropriate device selection (pMDI with spacer and facemask if needed), a secure facemask seal, and active child cooperation.
  • Effective aerosol therapy hinges on minimizing leaks, ensuring quiet breathing, and utilizing small particle aerosols.

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