Masks for Treating Asthma Not Always Effective

Vol. 19 •Issue 5 • Page 34
Inside Industry

Masks for Treating Asthma Not Always Effective

Some face masks commonly used to help young children inhale asthma medicine are not effective, according to a new study by researchers from Wake Forest University School of Medicine. The results are reported in a January issue of Respiratory Care.

“With some masks, the amount of medicine available to the youngest children is severely decreased because of mask size, stiffness and poor fit on the face,” said Bruce Rubin, MD, a professor of pediatrics. Rubin is a pediatric pulmonary specialist, a professor of biomedical engineering in the Wake Forest-Virginia Tech Biomedical Engineering and Sciences and an aerosol scientist.

Researchers studied seven masks used in combination with pressurized metered-dose inhalers to deliver asthma medicine to children.

Some masks didn’t fit well and some had too much dead space volume.

“Dead space volume in the mask contains drugs that don’t get into the lung with each breath,” said Rubin, who practices at Brenner Children’s Hospital.

Masks were measured by filling each with water after sealing the outlet end. Then, using an infant-sized mannequin head that is used to teach cardiopulmonary resuscitation, they measured the dead space volume of the masks.

With masks that fit better on the face and were flexible, more water was pushed out at each force and less remained in the mask as dead space volume.

Researchers also measured how well the mask fit on the face by analyzing digital photographs to determine whether there was any leak.

Dead space volume ranged from 20 ml to 100 ml–with the higher number meaning that less medicine gets to the lungs. Three masks had dead space volume that was low enough for the mask to be emptied with the normal breathing of a six-month-old infant.

“The seal between the mask and the face is critical for drug delivery,” said Rubin. “If the mask doesn’t fit tightly enough, you’re sucking outside air that contains no medicine,” said Rubin.

The Wake Forest team also plans to evaluate how effectively medication is getting to the lungs by using the masks.

Exercise-Induced Asthma Prevalent in Athletes

Of the 2,500 athletes competing in the 2006 Winter Olympics in Torino, Italy, nearly one in six could suffer from exercise-induced asthma (EIA), according to the American Academy of Allergy, Asthma and Immunology (AAAAI).

The academy reports that EIA affects nearly 20 percent of highly competitive athletes. But the athletes should not let the asthma hinder their activity, experts advised.

“People who have EIA should not stop exercising,” said Timothy J. Craig, DO, FAAAAI, chair of the AAAAI’s Sports Medicine Committee. “Exercise is good for all people, including those with asthma. Certain activities are better for people suffering from EIA, although the type and duration of activities varies with each individual.”

Swimming, for example, has many positive factors for those with EIA. The horizontal position of swimming can help mobilize mucus from the bottom of the lungs. Plus, the warm, humid atmosphere, year-round availability and toning of upper body muscles helps decrease asthma symptoms.

Walking, leisure biking, hiking and free downhill skiing are also less likely to trigger EIA, according to the AAAI. Wearing a scarf or surgical mask in cold weather can decrease symptoms by warming the inhaled air.

Sports that require short bursts of energy, like baseball, football, wrestling, golfing, gymnastics, short-term track and field events or surfing, are also less likely to trigger EIA.

The AAAAI advises that athletes of all levels should take proper precautions if they have EIA. Exercise is beneficial to both physical health and emotional well-being.

The Olympic Games, which recently concluded in Italy, featured 15 winter sports including freestyle skiing, ice hockey, figure skating, speed skating and snowboarding.

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