Ari Arzu
Department of Respiratory Care, Texas State University, Round Rock, TX, USA.
Ann Transl Med. 2021 Apr;9(7):593. doi: 10.21037/atm-20-1682.
Although using aerosolized medications is a mainstay of treatment in children with asthma and other respiratory diseases, there are many issues in terms of device and interface selection, delivery technique and dosing, as well as patient and parental education that have not changed for half a century. Also, due to many aerosol devices and interfaces available on the market and the broad range of patient characteristics and requirements, providing effective aerosol therapy to children becomes a challenge. While aerosol delivery devices are equally effective, if they are age-appropriate and used correctly, the majority of aerosol devices require multiple steps to be used efficiently. Unfortunately, many children with pulmonary diseases have problems with the correct delivery technique and do not gain therapeutic benefits from therapy that result in poor disease management and increased healthcare costs. Therefore, the purpose of this paper is to review the current knowledge on aerosol delivery devices used in children and guide clinicians on the optimum device- and interface-selection, delivery technique, and dosing in this patient population. Strategies on how to deliver aerosolized medications in crying and distressed children and how to educate parents on aerosol therapy and promote patient adherence to prescribed medications are also provided. Future directions of aerosol therapy in children should focus on these issues and implement policies and clinical practices that highlight the potential solutions to these problems.
尽管使用雾化药物是哮喘和其他呼吸道疾病患儿治疗的主要手段，但在设备和接口选择、给药技术和剂量以及患者和家长教育方面存在许多问题，这些问题半个世纪以来一直没有改变。此外，由于市场上有许多雾化设备和接口，以及患者特征和需求的广泛差异，为儿童提供有效的雾化治疗成为一项挑战。虽然雾化给药设备如果适合年龄且使用正确同样有效，但大多数雾化设备需要多个步骤才能有效使用。不幸的是，许多患有肺部疾病的儿童在正确的给药技术方面存在问题，无法从治疗中获得治疗益处，导致疾病管理不善和医疗成本增加。因此，本文的目的是回顾目前关于儿童使用的雾化给药设备的知识，并指导临床医生在这一患者群体中进行最佳的设备和接口选择、给药技术和剂量确定。还提供了如何在哭闹和痛苦的儿童中给药雾化药物以及如何教育家长进行雾化治疗并促进患者遵医嘱用药的策略。儿童雾化治疗的未来方向应关注这些问题，并实施突出这些问题潜在解决方案的政策和临床实践。
