The Science Journal of the American Association for Respiratory Care

2004 OPEN FORUM Abstracts

EFFECTS OF fACEMASK DESIGN ON FACIAL AND Ocular DEPOSITION OF NEBULIZED BUDESONIDE

G.C. Smaldone MD, PhD1, S. Sangwan MD2, A. Shah MD1. 1SUNY at Stony Brook NY, 2Mercy Catholic Medical Center, Darby, PA

Background: Recent in vitro studies have indicated that aerosol therapy using nebulizers and facemasks can result in drug deposition on the face and in the eyes. Facemask design and nebulizer characteristics are important determinants of this deposition1. The present paper tests different nebulizers and mask designs for budesonide, a nebulized steroid used to treat patients with asthma.

Methods: Drug delivery (Inhaled Mass) and facial deposition of radiolabeled saline aerosols were studied in vitro with a gamma camera and a face facsimile1. Results were compared to an identical protocol using 2.0 mL nebulized budesonide (0.250 mg/mL) analyzed by HPLC. Facial and eye deposition were measured for a tight fitting test mask (Laerdal), a standard commercial mask (Salter) and a prototype mask designed to optimize delivery by reducing the ballistic component of aerosolized particles. Particle size was measured by cascade impaction. The face model was ventilated with a tidal volume of 50 mL, respiratory rate 25 min and duty cycle 0.4. Laerdal and Prototype masks used Pari LC jet+ nebulizer while Standard mask used the Salter NebuTech HDN nebulizer.

Results:

Table 1: Facial Deposition for 99mTc Saline Aerosols (% nebulizer charge)

Mask Type Inhaled Mass Face Eyes MMAD µm
Laerdal 6.7±0.76 2.11±0.32 1.45±0.31 6.6
Standard 1.93±0.28 1.70±0.22 0.35±0.05 7.6
Prototype 9.59±1.50 0.83±0.07 0.11±0.01 5.8

Table 2: Facial Deposition for HPLC Measured Budesonide

Laerdal 14.43±0.67 6.51±0.13 4.77±0.23 7.8
Standard 3.03±1.83 3.07±0.53 1.51±0.08 9.9
Prototype 13.21±1.83 1.33±0.24 0.35±0.05 7.6

Conclusions: Reducing the local ballistic component of aerosolized particles (saline or budesonide) minimizes facial deposition while enhancing drug delivery to the patient. Specific design changes in the region of the eyes as well as the shape of the mask greatly reduced facial deposition and virtually eliminated eye deposition. 1Pediatric Pulmonology. 2004; 37:447-452.

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