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Aerosol delivery of nebulised budesonide in young children with asthma

Karen G Schueepp1, Sunalene G Devadason, Christina Roller

  • 1Department of Pediatrics and Respiratory Medicine, University Children's Hospital, Berne, Switzerland. karen.schuepp@insel.ch

Respiratory Medicine
|June 23, 2009
PubMed

Insights

Improving aerosol therapy for young children with asthma is crucial. A modified nebuliser significantly enhanced lung deposition of budesonide, but child cooperation remains a key challenge.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Drug Delivery
  • Asthma Management

Background:

  • Lung deposition of inhaled corticosteroids is suboptimal in young children with asthma due to anatomical, physiological, and cooperation factors.
  • Low lung deposition impacts treatment efficacy and increases the risk of systemic side effects.
  • Optimizing aerosol delivery is critical for effective anti-inflammatory treatment in pediatric asthma.

Purpose of the Study:

  • To evaluate lung deposition and lung-to-oropharyngeal deposition ratio of budesonide using a modified vibrating membrane nebuliser in young children.
  • To assess the impact of a small particle size formulation delivered via an age-adjusted device on aerosol deposition.
  • To determine the efficacy of a novel delivery system in addressing the challenges of pediatric aerosol therapy.

Main Methods:

  • Ten asthmatic children (mean age 20.3 months) inhaled radiolabeled budesonide (MMD 2.6 µm) via a modified vibrating membrane nebuliser (PARI e-Flow).
  • Lung deposition was quantified using scintigraphy, measuring the percentage of the emitted dose.
  • The ratio of lung deposition to oropharyngeal deposition was calculated to assess drug distribution.

Main Results:

  • Mean lung deposition was 48.6% in quietly breathing children and 20.0% when crying.
  • The lung-to-oropharyngeal deposition ratio was 1.0 for quiet breathing versus 0.3 when crying.
  • The modified device demonstrated significantly higher lung deposition and improved deposition ratios compared to crying conditions.

Conclusions:

  • An optimized combination of delivery device and small-particle drug formulation significantly improves lung deposition and lung-to-oropharyngeal deposition ratio in young asthmatic children.
  • Despite technological advancements, patient cooperation remains the primary limitation for effective aerosol delivery in this age group.
  • This improved delivery system holds promise for enhancing asthma management in pediatric populations.
Abstract

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