Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1992 Jan;67(1 Spec No):25–30. doi: 10.1136/adc.67.1_spec_no.25

Delivery of therapeutic aerosols to intubated babies.

J Grigg 1, S Arnon 1, T Jones 1, A Clarke 1, M Silverman 1
PMCID: PMC1590326  PMID: 1536581

Abstract

Delivery of drug aerosols to the lungs of ventilated neonates by metered dose inhaler and spacer (Aerochamber) and ultrasonic nebuliser (Pentasonic) was assessed using sodium cromoglycate. The mean proportion of a known intratracheal dose of sodium cromoglycate excreted in the urine of four intubated infants was 37.5%. After assuming that 38% of the sodium cromoglycate aerosol reaching the neonatal lung will be excreted in the urine, three puffs (15 mg) delivered by metered dose inhaler and spacer resulted in a pulmonary dose of 258 micrograms (1.7%, n = 7). A dose of 20 mg (4 ml) sodium cromoglycate ultrasonically nebulised over five minutes into the inspiratory limb of a standard ventilator circuit produced a pulmonary dose of 257 micrograms (1.3%, n = 7). Of two in vitro lung models assessed, a combination of filter and neonatal test lung was superior to a multistage impactor in estimating the in vivo pulmonary sodium cromoglycate dose delivered by metered dose inhaler and spacer (243 micrograms v 1740 micrograms).

Full text

PDF
25

Images in this article

26Figure 1
on p.26
26Figure 2
on p.26

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brown K., Gardner J. J., Lockley W. J., Preston J. R., Wilkinson D. J. Radioimmunoassay of sodium cromoglycate in human plasma. Ann Clin Biochem. 1983 Jan;20(Pt 1):31–36. doi: 10.1177/000456328302000105. [DOI] [PubMed] [Google Scholar]
  2. Brundage K. L., Mohsini K. G., Froese A. B., Fisher J. T. Bronchodilator response to ipratropium bromide in infants with bronchopulmonary dysplasia. Am Rev Respir Dis. 1990 Nov;142(5):1137–1142. doi: 10.1164/ajrccm/142.5.1137. [DOI] [PubMed] [Google Scholar]
  3. Cameron D., Arnot R., Clay M., Silverman M. Aerosol delivery in neonatal ventilator circuits: a rabbit lung model. Pediatr Pulmonol. 1991;10(3):208–213. doi: 10.1002/ppul.1950100314. [DOI] [PubMed] [Google Scholar]
  4. Cameron D., Clay M., Silverman M. Evaluation of nebulizers for use in neonatal ventilator circuits. Crit Care Med. 1990 Aug;18(8):866–870. doi: 10.1097/00003246-199008000-00015. [DOI] [PubMed] [Google Scholar]
  5. Clarke S. W., Newman S. P. Differences between pressurized aerosol and stable dust particles. Chest. 1981 Dec;80(6 Suppl):907–909. [PubMed] [Google Scholar]
  6. Clay M. M., Pavia D., Newman S. P., Lennard-Jones T., Clarke S. W. Assessment of jet nebulisers for lung aerosol therapy. Lancet. 1983 Sep 10;2(8350):592–594. doi: 10.1016/s0140-6736(83)90679-7. [DOI] [PubMed] [Google Scholar]
  7. Dhand R., Malik S. K., Balakrishnan M., Verma S. R. High speed photographic analysis of aerosols produced by metered dose inhalers. J Pharm Pharmacol. 1988 Jun;40(6):429–430. doi: 10.1111/j.2042-7158.1988.tb06308.x. [DOI] [PubMed] [Google Scholar]
  8. Fuller H. D., Dolovich M. B., Posmituck G., Pack W. W., Newhouse M. T. Pressurized aerosol versus jet aerosol delivery to mechanically ventilated patients. Comparison of dose to the lungs. Am Rev Respir Dis. 1990 Feb;141(2):440–444. doi: 10.1164/ajrccm/141.2.440. [DOI] [PubMed] [Google Scholar]
  9. Marks L. B., Notter R. H., Oberdorster G., McBride J. T. Ultrasonic and jet aerosolization of phospholipids and the effects on surface activity. Pediatr Res. 1983 Sep;17(9):742–747. doi: 10.1203/00006450-198309000-00012. [DOI] [PubMed] [Google Scholar]
  10. Neale M. G., Brown K., Hodder R. W., Auty R. M. The pharmacokinetics of sodium cromoglycate in man after intravenous and inhalation administration. Br J Clin Pharmacol. 1986 Oct;22(4):373–382. doi: 10.1111/j.1365-2125.1986.tb02905.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Newman S. P., Morén F., Pavia D., Little F., Clarke S. W. Deposition of pressurized suspension aerosols inhaled through extension devices. Am Rev Respir Dis. 1981 Sep;124(3):317–320. doi: 10.1164/arrd.1981.124.3.317. [DOI] [PubMed] [Google Scholar]
  12. Newman S. P., Pellow P. G., Clarke S. W. In vitro comparison of DeVilbiss jet and ultrasonic nebulizers. Chest. 1987 Dec;92(6):991–994. doi: 10.1378/chest.92.6.991. [DOI] [PubMed] [Google Scholar]
  13. Richards R., Dickson C. R., Renwick A. G., Lewis R. A., Holgate S. T. Absorption and disposition kinetics of cromolyn sodium and the influence of inhalation technique. J Pharmacol Exp Ther. 1987 Jun;241(3):1028–1032. [PubMed] [Google Scholar]
  14. 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]
  15. Silverman M. Aerosol therapy in the newborn. Arch Dis Child. 1990 Aug;65(8):906–908. doi: 10.1136/adc.65.8.906. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Summers Q. A. Inhaled drugs and the lung. Clin Exp Allergy. 1991 May;21(3):259–268. doi: 10.1111/j.1365-2222.1991.tb01657.x. [DOI] [PubMed] [Google Scholar]
  17. Walker S. R., Evans M. E., Richards A. J., Paterson J. W. The fate of ( 14 C)disodium cromoglycate in man. J Pharm Pharmacol. 1972 Jul;24(7):525–531. doi: 10.1111/j.2042-7158.1972.tb09051.x. [DOI] [PubMed] [Google Scholar]
  18. Watterberg K. L., Clark A. R., Kelly H. W., Murphy S. Delivery of aerosolized medication to intubated babies. Pediatr Pulmonol. 1991;10(2):136–141. doi: 10.1002/ppul.1950100217. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES