Abstract
Background: Face mask (FM) fit is a key factor for low inspiratory flow rate (IFR) paediatric pMDI patients who require a VHC: preventing drug leakage, environmental air dilution, and inspiratory exertion.
Aim: To develop a small FM incorporating a positive audible whistle IFR signal (AW) that quantifies and qualifies FM use, using a low-static non-silicone flexible polymer identified from previous research (J Aerosol Med 2014; 27[6]:A-8; ibid 2015; 28[3]:P-137).
Methods: 24 healthy volunteers aged 1.6-9.2 years (mean 5.5) were asked to use the development-FM absent prior training or incentive to achieve AW. AW comprised a reed tuned to sound at ≥20L/min. FM included a restrictor to mimic the 210mL Able Spacer®-2 VHC. At 20L/min IFR, VHC volume is cleared in 0.65 seconds, with the AW providing feedback of VHC emptying. FM visual fit (VF) and AW were assessed by parent and/or carer. Separately, FMs were tested for their ability to drive a paediatric respiratory-focussed phone App.
Results: Two children (2.4y and 3.8y) were uncooperative and one (9.0y) required a larger mask. 16 children >3years (15 with good VF) generated the confirmatory AW. Four children (1.6-3.0y) failed to do so; whilst the remaining 2.3y-old did generate AW, but with effort. The FM AW was compatible with the App.
Conclusion: The new paediatric FM with AW guidance was used successfully by all subjects aged >3 years, suggesting it is a useful, simple training tool. We note with caution that children ≤3 years do require coaxing to establish cooperation. This requires further thought and study, as does the short VHC clearance time which suggests that repeated tidal breaths may not contribute to better delivery.
- Copyright ©the authors 2016
