Griffioen R W, de Jongh F H
Emma Kinderziekenhuis AMC, afd. Kinderpulmonologie, Amsterdam.
Ned Tijdschr Geneeskd. 1998 Jun 27;142(26):1484-8.
Effective inhalation of drugs, even by small children under 2 years, is often faster, simpler, cheaper and better with metered dose inhalers with small antistatic (metal) inhalation chambers than with nebulisation. This is also true during considerable bronchial obstruction. It is mandatory that the inhalation chamber has a small dead space and well functioning valves opening at low flows. Effective dosing in small children is enhanced by more doses, given separately, while choosing the highest dose per spray available. Important factors determining bronchial deposition in small children are breathing frequency, tidal volume and the degree of bronchial obstruction and nasal obstruction, since inhalation goes primarily through the nose. If well-performed medication with a small inhalation chamber is clinically ineffective, it is better to start systemic medication, e.g. a corticosteroid, or even to consider artificial ventilation, rather than to try nebulisation. Better effective deposition is possible with inhalation of drugs in hydrofluoroalkane (HFA) aerosols, which will replace chlorofluorocarbon (CFC) aerosols in the near future.
对于两岁以下的幼儿，使用带有小型抗静电（金属）吸入室的定量吸入器有效吸入药物，通常比雾化吸入更快、更简便、更便宜且效果更好。在严重支气管阻塞时也是如此。吸入室必须具有小的死腔和在低流量时能良好工作的阀门。对于幼儿，通过分开给予更多剂量并选择每喷可用的最高剂量来增强有效给药效果。决定幼儿支气管药物沉积的重要因素包括呼吸频率、潮气量以及支气管阻塞和鼻阻塞的程度，因为吸入主要通过鼻腔进行。如果使用小型吸入室进行的药物治疗在临床上无效，最好开始全身用药，例如皮质类固醇，甚至考虑人工通气，而不是尝试雾化吸入。吸入氢氟烷烃（HFA）气雾剂的药物可能实现更好的有效沉积，在不久的将来，HFA气雾剂将取代氯氟烃（CFC）气雾剂。
