Abstract
The efficacy of a new valved spacer device, the Babyhaler inhaler (Glaxo) for administering metered dose inhaler treatment via a facemask to infants was assessed. In a double blind, single dose study, salbutamol (800 micrograms) or placebo were given on separate days to 12 sedated, sleeping, wheezy infants during a symptom free interval. Lung function was measured before and after administration and the bronchial response to aerosol challenge with methacholine was then assessed using the squeeze technique. A small increase in heart rate and a drop in arterial oxygen tension followed salbutamol administration. No other change in lung volume or air flow obstruction was detected. Bronchial responsiveness decreased significantly after the administration of salbutamol by Babyhaler, the PC30 (provoking concentration of methacholine causing a 30% fall in maximal flow at functional residual capacity by the squeeze technique) increasing from a median of 3.8 g/l after placebo to 12.5 g/l after salbutamol. The Babyhaler is an effective device for administering bronchodilator to wheezy infants. The small scale of the response may be attributable to the uncertain effect of beta agonists in this population. Furthermore, pulmonary deposition of inhaled aerosols may be reduced in nose breathing, sleeping infants.
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- Asthma: a follow up statement from an international paediatric asthma consensus group. Arch Dis Child. 1992 Feb;67(2):240–248. doi: 10.1136/adc.67.2.240. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bentur L., Canny G. J., Shields M. D., Kerem E., Schuh S., Reisman J. J., Fakhoury K., Pedder L., Levison H. Controlled trial of nebulized albuterol in children younger than 2 years of age with acute asthma. Pediatrics. 1992 Jan;89(1):133–137. [PubMed] [Google Scholar]
- Clarke J. R., Reese A., Silverman M. Bronchial responsiveness and lung function in infants with lower respiratory tract illness over the first six months of life. Arch Dis Child. 1992 Dec;67(12):1454–1458. doi: 10.1136/adc.67.12.1454. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Conner W. T., Dolovich M. B., Frame R. A., Newhouse M. T. Reliable salbutamol administration in 6- to 36-month-old children by means of a metered dose inhaler and Aerochamber with mask. Pediatr Pulmonol. 1989;6(4):263–267. doi: 10.1002/ppul.1950060410. [DOI] [PubMed] [Google Scholar]
- Everard M. L., Clark A. R., Milner A. D. Drug delivery from holding chambers with attached facemask. Arch Dis Child. 1992 May;67(5):580–585. doi: 10.1136/adc.67.5.580. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Greenough A., Pool J., Price J. F. Changes in functional residual capacity in response to bronchodilator therapy among young asthmatic children. Pediatr Pulmonol. 1989;7(1):8–11. doi: 10.1002/ppul.1950070104. [DOI] [PubMed] [Google Scholar]
- Kraemer R., Birrer P., Modelska K., Aebischer C. C., Schöni M. H. A new baby-spacer device for aerosolized bronchodilator administration in infants with bronchopulmonary disease. Eur J Pediatr. 1992 Jan;151(1):57–60. doi: 10.1007/BF02073894. [DOI] [PubMed] [Google Scholar]
- Kraemer R., Frey U., Sommer C. W., Russi E. Short-term effect of albuterol, delivered via a new auxiliary device, in wheezy infants. Am Rev Respir Dis. 1991 Aug;144(2):347–351. doi: 10.1164/ajrccm/144.2.347. [DOI] [PubMed] [Google Scholar]
- Le Souëf P. N., Hughes D. M., Landau L. I. Effect of compression pressure on forced expiratory flow in infants. J Appl Physiol (1985) 1986 Nov;61(5):1639–1646. doi: 10.1152/jappl.1986.61.5.1639. [DOI] [PubMed] [Google Scholar]
- Lesouëf P. N., Geelhoed G. C., Turner D. J., Morgan S. E., Landau L. I. Response of normal infants to inhaled histamine. Am Rev Respir Dis. 1989 Jan;139(1):62–66. doi: 10.1164/ajrccm/139.1.62. [DOI] [PubMed] [Google Scholar]
- Mallol J., Barrueto L., Girardi G., Toro O. Bronchodilator effect of fenoterol and ipratropium bromide in infants with acute wheezing: use of MDI with a spacer device. Pediatr Pulmonol. 1987 Sep-Oct;3(5):352–356. doi: 10.1002/ppul.1950030511. [DOI] [PubMed] [Google Scholar]
- Maxwell D. L., Prendiville A., Rose A., Silverman M. Lung volume changes during histamine-induced bronchoconstriction in recurrently wheezy infants. Pediatr Pulmonol. 1988;5(3):145–151. doi: 10.1002/ppul.1950050305. [DOI] [PubMed] [Google Scholar]
- O'Callaghan C., Milner A. D., Swarbrick A. Spacer device with face mask attachment for giving bronchodilators to infants with asthma. BMJ. 1989 Jan 21;298(6667):160–161. doi: 10.1136/bmj.298.6667.160. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Prendiville A., Green S., Silverman M. Airway responsiveness in wheezy infants: evidence for functional beta adrenergic receptors. Thorax. 1987 Feb;42(2):100–104. doi: 10.1136/thx.42.2.100. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Prendiville A., Green S., Silverman M. Bronchial responsiveness to histamine in wheezy infants. Thorax. 1987 Feb;42(2):92–99. doi: 10.1136/thx.42.2.92. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Salmon B., Wilson N. M., Silverman M. How much aerosol reaches the lungs of wheezy infants and toddlers? Arch Dis Child. 1990 Apr;65(4):401–403. doi: 10.1136/adc.65.4.401. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Silverman M., Prendiville A., Green S. Partial expiratory flow-volume curves in infancy: technical aspects. Bull Eur Physiopathol Respir. 1986 May-Jun;22(3):257–262. [PubMed] [Google Scholar]
- Stick S. M., Arnott J., Turner D. J., Young S., Landau L. I., Lesouëf P. N. Bronchial responsiveness and lung function in recurrently wheezy infants. Am Rev Respir Dis. 1991 Nov;144(5):1012–1015. doi: 10.1164/ajrccm/144.5.1012. [DOI] [PubMed] [Google Scholar]
- Tepper R. S. Airway reactivity in infants: a positive response to methacholine and metaproterenol. J Appl Physiol (1985) 1987 Mar;62(3):1155–1159. doi: 10.1152/jappl.1987.62.3.1155. [DOI] [PubMed] [Google Scholar]
- Tepper R. S., Morgan W. J., Cota K., Wright A., Taussig L. M. Physiologic growth and development of the lung during the first year of life. Am Rev Respir Dis. 1986 Sep;134(3):513–519. doi: 10.1164/arrd.1986.134.3.513. [DOI] [PubMed] [Google Scholar]
- Yuksel B., Greenough A., Maconochie I. Effective bronchodilator treatment by a simple spacer device for wheezy premature infants. Arch Dis Child. 1990 Jul;65(7):782–785. doi: 10.1136/adc.65.7.782. [DOI] [PMC free article] [PubMed] [Google Scholar]