Spacer inhalation technique and deposition of extrafine aerosol in asthmatic children

• Published in: The European respiratory journal Vol. 29; no. 2; pp. 299 - 306
• Main Authors: Roller, C. M, Zhang, G, Troedson, R. G, Leach, C. L, Le Souef, P. N, Devadason, S. G
• Format: Journal Article
• Language: English
• Published: Leeds Eur Respiratory Soc 01-02-2007; Maney
• Subjects: Administration, Inhalation; Adolescent; Aerosols; Anti-Asthmatic Agents - administration & dosage; Anti-Asthmatic Agents - pharmacokinetics; Asthma - drug therapy; Beclomethasone - administration & dosage; Beclomethasone - analogs & derivatives; Beclomethasone - analysis; Beclomethasone - pharmacokinetics; Biological and medical sciences; Child; Child, Preschool; Chronic obstructive pulmonary disease, asthma; Female; Gastrointestinal Tract - diagnostic imaging; Gastrointestinal Tract - metabolism; Humans; Lung - diagnostic imaging; Lung - metabolism; Male; Medical sciences; Metered Dose Inhalers; Oropharynx - diagnostic imaging; Oropharynx - metabolism; Pneumology; Radionuclide Imaging; Tissue Distribution; Human; Lung disease; inhalation technique; Respiratory disease; Inhalation spacer; Asthma; Inhalation; Spacer; spacers; Bronchus disease; Aerosol deposition; Obstructive pulmonary disease; Technique; Children; Child; deposition study; Pneumology
• ISSN: 0903-1936; 1399-3003
• DOI: 10.1183/09031936.00051106

The aim of the present study was to measure airway, oropharyngeal and gastrointestinal deposition of (99m)Tc-labelled hydrofluoroalkane-beclomethasone dipropionate after inhalation via a pressurised metered-dose inhaler and spacer (Aerochamber Plus) in asthmatic children. A group of 24 children (aged 5-17 yrs) with mild asthma inhaled the labelled drug. A total of 12 children took five tidal breaths after each actuation (tidal group). The other 12 children used a slow maximal inhalation followed by a 5 - 10-s breath-hold (breath-hold group). Simultaneous anterior and posterior planar gamma-scintigraphic scans (120-s acquisition) were recorded. For the tidal group, mean+/-sd lung deposition (% ex-actuator, attenuation corrected) was 35.4+/-18.3, 47.5+/-13.0 and 54.9+/-11.2 in patients aged 5-7 (n = 4), 8-10 (n = 4) and 11-17 yrs (n = 4), respectively. Oropharyngeal and gastrointestinal deposition was 24.0+/-10.5, 10.3+/-4.4 and 10.1+/-6.2. With the breath-hold technique, lung deposition was 58.1+/-6.7, 56.6+/-5.2 and 58.4+/-9.2. Oropharyngeal and gastrointestinal deposition was 12.9+/-3.2, 20.1+/-9.5 and 20.8+/-8.8. Inhalation of the extrafine formulation with the breath-hold technique showed significantly improved lung deposition compared with tidal breathing across all ages. Oropharyngeal and gastrointestinal deposition was markedly decreased, regardless of which inhalation technique was applied, compared with a previous paediatric study using the same formulation delivered via a breath-actuated metered-dose inhaler.