Aerosol Delivery to Spontaneously Breathing Neonates: Spacer or Nebulizer?

Abstract

Aims

: We chose to compare aerosol delivery from a nebulizer and a pressurized metereddose inhaler (pMDI) through a small-volume spacer in spontaneously breathing newborn infants.

Methods

: Twenty-four neonates (weight 1800g-5260g) inhaled salbutamol solution from a Pari-Baby nebulizer and salbutamol puffs from a pMDI through a Nebuchamber in random order. A filter was placed between the inhalation systems and the airway opening.

Results

: The amount of drug deposited on the filter (expressed as percentage of the total nebulized or actuated doses) was higher with the pMDI plus the Nebuchamber than with the Pari-Baby (39.3 ± 2.0% vs. 21.6 ± 2.1%). Body weight and crying did not influence drug delivery.

Conclusions

: Aerosol delivery to spontaneously breathing neonates with a pMDI through a small-volume spacer provides a viable alternative to nebulizer therapy.