Mask Use with Spacers/Valved Holding Chambers and Metered Dose Inhalers among Children with Asthma

Reply: Utility of a Mask with a Spacer to Deliver the Contents of a Metered Dose Inhaler

“…We appreciate the letter by Tualzik and Chandrasekaran that details specific situations in which masks should be used with metered dose inhalers (MDI) and spacers. We concur that there may be situations where it may be appropriate for a child to use an MDI with a spacer and mask, regardless of age 1 . Effective use of an inhaler with spacer and mouthpiece requires coordination by an individual, wherein they must make a tight seal around the mouthpiece and control their breathing.…”

Strategies for Improving Inhalation Technique in Children: A Narrative Review

“…For instance, younger patients require both a mask and spacers with MDIs, while older patients can effectively use just a spacer with MDIs. 17 No guidelines establish what factors should drive this change or at what age this change should occur, though it is typically posited to be around 5 years of age. 17 In addition to age as a factor for proper technique, inhaler devices differ in terms of how easy or difficult it is to use them.…”

“…17 No guidelines establish what factors should drive this change or at what age this change should occur, though it is typically posited to be around 5 years of age. 17 In addition to age as a factor for proper technique, inhaler devices differ in terms of how easy or difficult it is to use them. 18 Devices that are generally considered easier to use include diskus, turbohaler, and ellipta, because the steps required for effective use are more obvious and/or it is more difficult to conduct critical errors.…”

“… 17 No guidelines establish what factors should drive this change or at what age this change should occur, though it is typically posited to be around 5 years of age. 17 …”

Utility of a Mask with a Spacer to Deliver the Contents of a Metered Dose Inhaler

“…We read with interest, the article by Volerman published online in the annals of the American Thoracic Society, in which she has brought out the inconsistencies in the recommendations concerning the use of spacers and masks in children on therapy with metered dose inhalers aptly. 1 She also goes on to discuss how some clinicians are continuing to recommend the use of mask with spacers based on their beliefs in children beyond the recommended ages. She discusses the need for focussed research in these areas which is a welcome move.…”