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.