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):20–24. doi: 10.1136/adc.67.1_spec_no.20

Evaluation of techniques for delivery of steroids to lungs of neonates using a rabbit model.

C O'Callaghan 1, J Hardy 1, J Stammers 1, T J Stephenson 1, D Hull 1
PMCID: PMC1590328  PMID: 1307678

Abstract

Little is known about delivery of aerosolised steroids to neonatal patients undergoing assisted positive pressure ventilation and after extubation. A rabbit model has been established to investigate factors influencing drug delivery. Beclomethasone dipropionate, in a metered dose inhaler, was radiolabelled with technetium 99m. The mass median aerodynamic diameter of the aerosol was 3.3 (2.0) microns and the impactor measurements confirmed that the technetium distribution corresponded with that of the drug particles. The metered dose inhaler was actuated into a collapsible spacer that was used to ventilate and deliver aerosol to anaesthetised rabbits by a tracheostomy. From each actuation of the drug 2.9 (0.4)% of the aerosol deposited in the trachea and main bronchi and 1.2 (0.4)% in the lung. When the drug was delivered by a spacer device, with face-mask attachment, to rabbits breathing freely through a tracheostomy, aerosol deposition increased to 4.4 (2.1)% in the trachea and main bronchi and 1.9 (0.9)% in the lung lobes. The maximum change in systolic blood pressure after administration of aerosol by the collapsible spacer was a decrease of 13%. The methods described may prove useful for the delivery of inhaled steroids to neonatal patients likely to develop bronchopulmonary dysplasia.

Full text

PDF

Selected References

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

  1. Alkalay A. L., Pomerance J. J., Puri A. R., Lin B. J., Vinstein A. L., Neufeld N. D., Klein A. H. Hypothalamic-pituitary-adrenal axis function in very low birth weight infants treated with dexamethasone. Pediatrics. 1990 Aug;86(2):204–210. [PubMed] [Google Scholar]
  2. Bisgaard H., Munck S. L., Nielsen J. P., Petersen W., Ohlsson S. V. Inhaled budesonide for treatment of recurrent wheezing in early childhood. Lancet. 1990 Sep 15;336(8716):649–651. doi: 10.1016/0140-6736(90)92147-a. [DOI] [PubMed] [Google Scholar]
  3. Brain J. D., Knudson D. E., Sorokin S. P., Davis M. A. Pulmonary distribution of particles given by intratracheal instillation or by aerosol inhalation. Environ Res. 1976 Feb;11(1):13–33. doi: 10.1016/0013-9351(76)90107-9. [DOI] [PubMed] [Google Scholar]
  4. 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]
  5. 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]
  6. Cummings J. J., D'Eugenio D. B., Gross S. J. A controlled trial of dexamethasone in preterm infants at high risk for bronchopulmonary dysplasia. N Engl J Med. 1989 Jun 8;320(23):1505–1510. doi: 10.1056/NEJM198906083202301. [DOI] [PubMed] [Google Scholar]
  7. Flavin M., MacDonald M., Dolovich M., Coates G., O'Brodovich H. Aerosol delivery to the rabbit lung with an infant ventilator. Pediatr Pulmonol. 1986 Jan-Feb;2(1):35–39. doi: 10.1002/ppul.1950020110. [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. Katz R., McWilliams B. Bronchopulmonary dysplasia in the pediatric intensive care unit. Crit Care Clin. 1988 Oct;4(4):755–787. [PubMed] [Google Scholar]
  10. 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]
  11. O'Callaghan C. Particle size of beclomethasone dipropionate produced by two nebulisers and two spacing devices. Thorax. 1990 Feb;45(2):109–111. doi: 10.1136/thx.45.2.109. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. 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]
  13. Stokes G. M., Milner A. D., Wilson A. J., Morgan D. B., Carman P. G., Oliver M. R. Ventilatory response to increased dead spaces in the first week of life. Pediatr Pulmonol. 1986 Mar-Apr;2(2):89–93. doi: 10.1002/ppul.1950020206. [DOI] [PubMed] [Google Scholar]
  14. 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