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Paediatrics
Research
Feasibility of aerosol drug delivery to sleeping infants: a prospective observational study
  1. Israel Amirav1,2,
  2. Michael T Newhouse3,
  3. Anthony Luder1,
  4. Asaf Halamish4,
  5. Hamza Omar5,
  6. Miguel Gorenberg5
  1. 1Pediatric Department, Ziv Medical Center, Faculty of Medicine, Bar-Ilan University, Safed, Israel
  2. 2Pediatric Department, University of Alberta, Edmonton, Canada
  3. 3Technosaf, Karkur, Israel
  4. 4Nuclear Medicine Department, Ziv Medical Center, Safed, Israel
  5. 5Firestone Institute for Respiratory Health, St Joseph's Hospital, McMaster University, Hamilton, Ontario, Canada
  1. Correspondence to Dr Israel Amirav; amirav{at}012.net.il

Abstract

Objectives Delivery of inhaled medications to infants is usually very demanding and is often associated with crying and mask rejection. It has been suggested that aerosol administration during sleep may be an attractive alternative. Previous studies in sleeping children were disappointing as most of the children awoke and rejected the treatment. The SootherMask (SM) is a new, gentle and innovative approach for delivering inhaled medication to infants and toddlers. The present pilot study describes the feasibility of administering inhaled medications during sleep using the SM.

Design Prospective observational study.

Setting Out patients.

Participants 13 sleeping infants with recurrent wheezing who regularly used pacifiers and were <12 months old.

Intervention Participants inhaled technetium99mDTPA-labelled normal saline aerosol delivered via a Respimat Soft Mist Inhaler (SMI) (Boehringer-Ingelheim, Germany) and SM + InspiraChamber (IC; InspiRx Inc, New Jersey, USA).

Outcomes The two major outcomes were the acceptability of the treatment and the lung deposition (per cent of emitted dose).

Results All infants who fulfilled the inclusion criteria successfully received the SM treatment during sleep without difficulty. Mean lung deposition (±SD) averaged 1.6±0.5% in the right lung.

Conclusions This study demonstrated that the combination of Respimat, IC and SM was able to administer aerosol therapy to all the sleeping infants who were regular pacifier users with good lung deposition. Administration of aerosols during sleep is advantageous since all the sleeping children accepted the mask and ensuing aerosol therapy under these conditions, in contrast to previous studies in which there was frequent mask rejection using currently available devices.

Clinical Trial Registry NCT01120938.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

https://doi.org/10.1136/bmjopen-2013-004124

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