Delivery of medication in aerosol form to the pediatric population is an important therapeutic module. Aerosol therapy allows rapid medication effects, reduces systemic side effects, and provides uniform results in comparable clinical presentations if preparation techniques and dosages are appropriate. The effectiveness of aerosol therapy is dependent upon several key factors, and techniques developed to emphasize these factors will maximize aerosol delivery into the tracheo bronchial tree. Indications for medical aerosol therapy are specific for children, and individualized treatment can be structured for a wide variety of pulmonary disorders. Proper and successful administration of aerosol therapy to the infant or child requires a comprehensive amount of skill and knowledge on the part of the respiratory therapy practitioner. Guidelines discussed in this paper will assist the respiratory care practitioner in achieving optimal results in treating airway disease in the pediatric patient.
Get full access to this article
View all access options for this article.
References
1.
Editorial. The proper use of aerosol bronchodilators. Lancet1981;1:23.
2.
Blackwell EW , Briant RH, Conolly ME, et al. Metabolism of isoprenaline after aerosol or direct intrabronchial administration in man and dog. Br J Pharmacol1974;50:587.
3.
Tabachnike LHClinical application of aerosols in pediatrics . Am Rev Respir Dis1980; 122:97.
4.
McFadden ERAerosolized bronchodilators and steroids in the treatment of airway obstruction in adults. Am Rev Respir Dis1980 ;122(Suppl):89.
5.
Newhouse MT, Ruffin REDeposition and fate of aerosolized drugs. Chest1978;73:936.
6.
Tobin MJ, Tenouri G., Danta I., et al. Response to bronchodilators drug administration by a new reservoir aerosol delivery system and a review of other auxilliary delivery systems . Am Rev Respir Dis1982;126:670.
7.
Hiller C., Mazumder M., Wilson D., et al. Aerodynamic size distribution of metered dose bronchodilator aerosols. Am Rev Respir Dis1978;118:311.
8.
Lippman M., Albert REThe effect of particle size on the regional deposition of inhaled aerosols in the human respiratory tract. Am Ind Hyg Assoc J1969;30:257,
9.
Pavia D., Thompson DCThe fractional deposition of inhaled 2 and 5 μm particles in the alveolar and tracheobronchial regions of healthy human lung. Ann Occup Hyg1976:19:109.
10.
Davies DSPharmacokinetics of inhaled substances. Postgrad Med J1975;(Suppl 7):69.
11.
Brain T.Aerosol and humidity therapy. Am Rev Respir Dis1980;122:17.
12.
Newman SP, Pavia D., Clarke SWHow should a pressurized β-adrenergic bronchodilator be inhaled ? Eur J Respir Dis1981;62:3-20.
13.
Riley JD, Liu RT, Edelman NHEnhanced responses to aerosolized bronchodilator therapy in asthma using respiratory maneuvers. Chest1979;76:501.
14.
Meade J., Turner JM, Macklem PT, et al. Significance of the relationship between lung recoil and maximum expiratory flow. J Appl Physiol1967;22:95.
15.
Linggren SB , Formgren H., Moren F.Improved aerosol therapy of asthma: effect of activator tube size on drug availability. Eur J Respir Dis1980;61:56.
16.
Godden DJ, Crompton GKAn objective assessment of the tube spacer in patients unable to use a conventional pressurized aerosol efficiently. Br J Dis Chest1981;75:165.
17.
Spicer JE, Cayton RE, Frame MH, et al. Influence of tube-spacer on aerosol efficiency. Lancet1980;2:1248.
18.
Koepke JW, Seiner JC, Dunhill ALPresence of sulfur dioxide in commonly used bronchodilator solutions . J Allergy Clin Immunol1983;72:504.
19.
Iravani J., Melville GN, Hurstmann G.N-acetylcysteine and mucociliary activity in mammalian airways. Arzneim Forsch1978;28:250.
20.
Carson S., Goldhamer R., Carpenter R.Responses of ciliated epithelium to irritants: mucus transport in the respiratory tract. Am Rev Respir Dis1966 :93:86.
21.
Eisenberg RS , Oatway WHNebulization of amphotericin B . Am Rev Respir Dis1971;193:289.
22.
Levine BA, Petroff PA, Slade L., et al. Prospective trials of dexamethaxone and aerosolized gentamicin in the treatment of inhalation injury in the burned patient. J Trauma1978;18:188.
23.
Freigang B.New method of beclomethasone aerosol administration to children under 4 years of age. Can Med Assoc J1977;177:1308.
24.
Chatterjee SSExperience with the use of a corticosteroid aerosol. Br J Clin Pharmacol1977;4(Suppl):255.
25.
Wyatt R., Waschek J., Weinberger M., et al. Effects of inhaled beclomethasone dipropionate and alternate-day prednisone on pituitary-adrenal function in children with chronic asthma. N Engl J Med1978;299:1387.
26.
Tobachnik E. , Levison H.Clinical application of aerosols in pediatrics . Am Rev Respir Dis1980;122(5):47.
27.
Adair JC, et al. Ten year experience with IPPB in the treatment of acute laryngotracheobronchitis . Anesth Analg1971;50:649.
28.
Huang NNThe guide to drug therapy for patients with cystic fibrosis. 2nd ed. Atlanta: The National Cystic Fibrosis Research Foundation, 1974:25.
29.
Dulfano MJ, Adler K., Wooten O.Physical properties of sputum. IV. Effects of 100 percent humidity and water mist. Am Rev Respir Dis1973;107:130.
30.
Wanner A., Rao A.Clinical indications for and effects of bland, mucolytic, and antimicrobial aerosols. Am Rev Respir Dis1980;122:80.
31.
Chinard FPThe permeability characteristics of the pulmonary blood-gas barrier . In: Caro CG, ed. Advances in respiratory physiology. Baltimore: Williams & Wilkins, 1966:106.
32.
Taussig L., Castro O., Beaudry PH, et al. Treatment of laryngotracheobronchitis. Am J Dis Child1975; 129:790.
33.
Barker GACurrent management of croup and epiglottitis. Pediatr Clin North Am1979;26:565.
34.
Banner AS, Shah RS, Addington WWRapid prediction of need for hospitalization in acute asthma. JAMA1976; 235:1337.
35.
Murray AB, Hardwick DF, Pirle GEAssessing severity of asthma with Wright peak flow meter. Lancet1977;1:708.
