Inhalation therapy in children

1 Clinical Department of Paediatrics, Paediatrics Clinic in Bytom, Faculty of Medical Sciences of the Medical University of Silesia in Katowice, Katowice, Poland. Head of the Department and Clinic: Professor Anna Obuchowicz, MD, PhD
2 Paediatric Unit, Regional Hospital in Strzelce Opolskie, Strzelce Opolskie, Poland. Head of the Department: Jarosław Mijas, MD, PhD
Correspondence: Jolanta Pietrzak, MD, PhD, Clinical Department of Paediatrics, Specialist Hospital No. 2, Batorego 15, 41-902 Bytom, Poland, tel.: +48 32 786 14 98, +48 601 450 175, e-mail:

Pediatr Med rodz Vol 10 Numer 4, p. 411–425
DOI: 10.15557/PiMR.2014.0042
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Inhalation is a form of treatment used in respiratory diseases that allows medications to be administered directly to
the affected site. Thanks to this, the administration of lower doses helps obtain a higher concentration in the target organ and
eliminate or effectively reduce systemic adverse effects. For drug deposition in the respiratory system, we use inhalers
(pressurised, dry powder, soft mist) or nebulisers (jet, ultrasonic, vibrating mesh). In pressurised inhalers, spacers or holding
chambers can be used to effectively synchronise inspiration with dose release. Inhalers are indicated in lower respiratory tract
diseases, and the only contraindication is the inability to use the device. Nebulisers can be used in upper and lower respiratory
tract diseases, but there are certain contraindications (among others: acute inflammation, flares of chronic diseases, circulatory
insufficiency). The selection of an inhaler (or a shift to another device) must be justified. It should be based on the knowledge
of the properties and principles of individual inhalers, assessment of the child’s ability to use the device properly (including
obtaining optimal inspiratory flows) as well as on the preferences of patients and their guardians. It is significant to
individually instruct the patient how to use an inhaler when this treatment is being implemented and to review the inhalation
technique during each follow-up visit. Treatment benefits can be achieved when age, clinical condition, proper inhalation
technique correlated with the abilities of patients are considered.

Keywords: inhalation therapy, inhaler, nebulisation, respiratory diseases, children