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A new baby-spacer device for aerosolized bronchodilator administration in infants with bronchopulmonary disease
R Kraemer1, P Birrer, K Modelska
1Department of Paediatrics, University of Berne, Inselspital, Switzerland.
Insights
Salbutamol administered via a metered dose inhaler and baby-spacer device effectively improved lung function in infants with bronchopulmonary disease. This bronchodilator treatment showed significant benefits, particularly after 600 micrograms of salbutamol.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
- Respiratory Medicine
Background:
- Infants with bronchopulmonary diseases often experience airway obstruction and hyperinflation.
- Effective delivery of inhaled medications in infants is challenging.
- Salbutamol is a common bronchodilator used to treat reversible airway obstruction.
Purpose of the Study:
- To evaluate the efficacy of salbutamol delivered via a metered dose inhaler (MDI) with a baby-spacer device in infants.
- To assess the dose-response relationship of salbutamol in improving lung function parameters in infants.
- To determine the usefulness of this delivery system for bronchodilator treatment in infants.
Main Methods:
- A study involving 14 infants (aged 2.9-18.8 months) with conditions like wheezing, cystic fibrosis, and post-respiratory distress syndrome.
- Whole-body plethysmography was used to measure changes in thoracic gas volume (TGV) and airway conductance (Gaw).
- Salbutamol (100 micrograms per puff) was administered incrementally up to 600 micrograms via MDI and baby-spacer, with lung function measured at intervals.
Main Results:
- Significant improvements in lung function were observed in 57.1% of infants after 400 micrograms of salbutamol.
- Lung function improved in 92.9% of infants after a cumulative dose of 600 micrograms.
- The study demonstrated a clear dose-dependent response to salbutamol in this infant population.
Conclusions:
- The metered dose inhaler (MDI) with a baby-spacer device is a useful system for delivering bronchodilators to infants.
- Salbutamol treatment is effective in improving lung function in infants with bronchopulmonary diseases.
- Optimal therapeutic outcomes require adherence to a specific dose-time regimen for salbutamol administration.
Abstract:
The response of salbutamol (Ventolin, Glaxo), topically administered from a metered dose inhaler (MDI) through a new baby-spacer-device (Babyhaler, Glaxo) was studied in 14 infants (8 wheezy infants, 3 infants with cystic fibrosis and 3 infants after respiratory distress syndrome), age 2.9-18.8 months. Changes in thoracic gas volume (TGV) as an estimate of pulmonary hyperinflation and changes in airway conductance (Gaw) as an estimate of bronchial obstruction were assessed by whole-body plethysmography. After baseline measurements, 1 puff of 100 micrograms salbutamol was given repeatedly at 5 min intervals until 600 micrograms have been inhaled and TGV and Gaw were measured after each inhalation at 5, 10, 15, 20, 25 and 30 min. Significant improvement in lung function was achieved in 57.1% of infants after 400 micrograms and in 92.9% of infants after 600 micrograms salbutamol. The study shows usefulness of bronchodilator treatment in infants with bronchopulmonary disease by a system with a MDI and baby-spacer-device. However a special dose-time relationship must be respected.