The Influence of a Nose-Clip on Inhalation Therapy in Asthmatic Children

In our study we investigated if wearing a nose-clip during inhalation therapy in asthmatic children changes breathing patterns and hence, influences aerosol delivery. Aerosol delivery was measured in 30 asthmatic children (age range 4-7 years) inhaling in random order with and without a nose-clip from both a pressurized metered-dose inhaler (pMDI) through a holding chamber and a nebulizer. Breathing patterns were measured using a pneumotachograph inserted between the delivery device and the patient. Aerosol delivery to the patient was measured on a filter inserted in the inspiratory limb of the system. Inspiratory volume and inspiratory flow were significantly higher when inhaling with a nose-clip from both a pMDI (p = 0.004; p = 0.025) and a nebulizer (p = 0.003; p = 0.038). Aerosol deposition on the inspiratory filter while inhaling from a nebulizer was significantly higher when wearing a nose-clip (p < 0.0005), but not while inhaling from a pMDI with holding chamber (p = 0.32). Aerosol delivery from a nebulizer is increased when inhaling with a nose-clip. This may have major implications on nebulized aerosol therapy.