Paediatric inhalation therapy in the upper airway  [ Return towards  Scientific information  ]

A. Varricchio, Tricarico, Varricchio

The success of inhalation therapy is closely linked with technical and non-technical factors. The main technical factors are the device used (endonasal and with MMAD >10 micron), the chemical and physical properties of the drug, hygroscopicity (which modifies the MMAD) and temperature. The non-technical factors are all essential: optimising compliance by reducing session times, assessing airway gauge, improving all the medical personnel's theoretical and practical knowledge, and informing the patient.
The choice of device depends on the region to be treated. The ERS's 2000 guidelines state that the device must atomise micelles with an MMAD of:
- > 10 microns for upper airway
- 5-10 microns for the middle airway
- 5-2 microns for the lower airway
The higher the particles' MMAD, the closer their deposition in the respiratory tree. Furthermore, by transporting high doses of drug, large particles considerably reduce treatment times.