A randomised controlled trial of breathing modes for adaptive aerosol delivery in children with cystic fibrosis

J Cyst Fibros. 2011 Sep;10(5):343-9. doi: 10.1016/j.jcf.2011.04.006. Epub 2011 May 28.


Background: Aerosol delivery is a cornerstone of CF airways disease management. New nebulisers have reduced treatment times by utilising mesh technology for aerosol production. We have evaluated a further modification (target inhalation mode (TIM)) that may reduce treatment delivery times further.

Methods: Following a baseline period on tidal breathing mode (TBM), children with CF on long-term aerosol therapy were randomly allocated to either TIM, which optimises patient inhalations through a direct feedback mechanism, or to continue TBM. The primary outcome was nebuliser treatment times with secondary outcomes being adherence and patient preference.

Results: The ten children allocated TIM reduced their mean (SD) treatment times from 6.9(2.9) to 3.7(2.3) minutes (p<0.001). In contrast, treatment times were unchanged in the ten children allocated TBM. Mean adherence was maintained in the TIM group but declined in patients allocated TBM by >5%. All children preferred TIM to TBM.

Conclusion: TIM reduces nebuliser treatment times and may positively impact on adherence, although longer duration studies are required to examine this. (ISRCTN65617839).

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Inhalation*
  • Adolescent
  • Anti-Bacterial Agents / administration & dosage*
  • Child
  • Child, Preschool
  • Cystic Fibrosis / drug therapy*
  • Deoxyribonuclease I / administration & dosage*
  • Female
  • Humans
  • Inhalation
  • Male
  • Nebulizers and Vaporizers*
  • Patient Compliance
  • Patient Preference
  • Saline Solution, Hypertonic / administration & dosage
  • Time Factors
  • Treatment Outcome


  • Anti-Bacterial Agents
  • Saline Solution, Hypertonic
  • DNASE1 protein, human
  • Deoxyribonuclease I

Associated data

  • ISRCTN/ISRCTN65617839