Some asthma face masks don't work well for kids

By David Douglas

NEW YORK (Reuters Health) - Face masks, used in combination with pressurized inhalers and holding chambers, are supposed to make it easier to treat asthma in young children. However, some masks cause discomfort and reduce the amount of medication kids end up getting, researchers report.

"Devices like face masks that were made for adults cannot just be made smaller and expected to work well for children," Dr. Bruce K. Rubin told Reuters Health.

Rubin, at Wake Forest University School of Medicine in Winston-Salem, North Carolina, and his colleagues point out that drug delivery can decrease when the volume of air enclosed by the mask is too great.

To look into the issue, the researchers used an experimental setup employing a mannequin of a 2-year-old's face to determine the fit and volume of seven commercially available masks. The findings appear in the medical journal Respiratory Care.

Fit improved with applied pressure, which ranged from 1.5 to 7 pounds of force. The Aerochamber and Optichamber sealed at 1.5 pounds. The Vortex, Ace Easivent and BreathRite achieved a good seal with increasing force. However, the Pocket Chamber did not seal at any tested force.

When the volume enclosed by the mask was measured, the investigators found that only the Aerochamber, Optichamber and Vortex had a volume "low enough for the mask contents to be emptied by the normal breathing of a 6-month-old infant."

While "a great deal of effort is appropriately directed toward developing more effective and safer medications," Rubin pointed out, "sometimes paying attention to the devices used to administer the medication will have a much greater impact on care and outcomes."

SOURCE: Respiratory Care, February 2006.