Randomized trial of spacers in asthma

Dahiya, Baljit; Mathew, Joseph L; Singh, Meenu

doi:10.1007/s12098-007-0112-0

Cited by 5 publications

(4 citation statements)

References 19 publications

(17 reference statements)

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“…Only a few trials have been undertaken to determine the efficacy of MDIs with spacers in giving albuterol to infants aged 2 and under. There was no controlled environment in these studies (double-blind design) and did not compare the efficacy of a spacerequipped MDI to that of a nebulizer (9) .…”

Section: Discussionmentioning

confidence: 99%

“…As spacers affect FEV1 and became higher than group 2 with nebulizers. Similarly, Dahiya et al (9) In a study of 150 children aged 5 to 14 years with persistent asthma presenting with peak expiratory flow, researchers compared the effectiveness of all types of spacers commonly used by children in India (PEF). They found that after inhaling a bronchodilator through each of the spacers, PEF and FEV1 improved significantly.…”

Section: Discussionmentioning

confidence: 99%

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Spacers versus Nebulizers in Treatment of Acute Asthma A Prospective Randomized Study in Preschool Children

Hamza

Harkan

2022

The Egyptian Journal of Hospital Medicine

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Background: Asthma affects approximately 14 million adult Americans and is responsible for over 450,000 hospitalizations each year. Every year, approximately 1.8 million asthma patients visit the emergency department. Aerosol delivery to mechanically ventilated patients utilizing nebulizers or metered dose inhalers (MDI) with spacers has been shown to be feasible and beneficial. Aim and Objectives: The goal of this study was to analyse MDI aerosol administration with spacer delivery and nebulizer among preschool kids. Material and Methods: A randomized, double-blind medical experiment involving 200 preschool children were divided into 2 groups received active drug either by nebulizer (group 1=100 patients) or MDI-spacer (group 2=100 patients). Assessment was done including clinical history, medications history, height, weight and BMI. All of the following parameters were measured: heart rate, respiratory rate, and arterial oxygen saturation while the children were awake and breathing room air. FEV1 was calculated using a portable spirometer. These clinical and laboratory tests were performed 10, 20, and 40 minutes after using the nebulizer. Results: The mean age in months was 25.4 ± 12.7 among group 1 and 26.6 ± 11.6 among group 2. Group 1 included 43% males and 57% females while group 2 included 52% males and 48% females. The mean BMI for age z score in group 1 was 0.31 & 0.97 and 0.32 & 0.89 in group 2. There was a statistically substantial variation between the two groups in terms of FEV1. In terms of heart rate, respiratory rate oxygen saturation, or hospital stay duration, there was no statistically substantial variation between the two groups. Conclusion:The MDI-spacer and the nebulizer both delivered salbutamol equally well aerosol therapy to preschool children suffering from wheezes and acute asthma exacerbations. The spacer had higher effect on FEV1 than nebulizer but there was no difference regarding oxygen saturation and hospital stay duration.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Spacers versus Nebulizers in Treatment of Acute Asthma A Prospective Randomized Study in Preschool Children

Hamza

Harkan

2022

The Egyptian Journal of Hospital Medicine

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“…Likewise, Dahiya et al., compared the efficacy of five types of spacers (a 750 ml spacer with valve, a 165 ml spacer with valve, a 250 ml spacer without valve, a 1000 ml indigenously made spacer without valve, and a 500 ml indigenously made spacer without valve) in 150 children 5–14 yrs of age with persistent asthma, using 200 μg of albuterol. They reported that changes in peak expiratory flow (PEF) and percentage improvement were comparable among all five groups and that changes in FEV 1 and percentage improvement were also comparable, irrespective of severity of baseline airway obstruction . Also, a recent Cochrane meta‐analysis that compares the efficacy of bronchodilator therapy given via commercially produced spacers (valved holding chambers) with home‐made spacers (non‐valved spacers) in children with acute exacerbation of bronchospasms or asthma did not identify a difference in any outcome between the two type of devices .…”

Section: Discussionmentioning

confidence: 99%

Comparison of the bronchodilating effects of albuterol delivered by valved vs. non‐valved spacers in pediatric asthma

Rodríguez‐Martínez

Sossa-Briceño²,

Castro-Rodriguez

2012

Pediatric Allergy Immunology

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“…Interestingly, five of the studies used plastic drink bottles, with one study also including a polystyrene cup [ 29 ] (which was the least effective), and the sixth, an unpublished study, utilizes a cardboard cone. Other randomized comparative clinical trials have led to more positive views: with no differences with a 150 mL paper disposable cup [ 30 ] or with plastic bottles [ 29 – 33 ]. The consensus seems clear, however, that use of a commercially made spacer device is, at all times, preferable to the use of a home-made device except where emergency situations or hygiene considerations dictate otherwise (and a commercially produced spacer is not available), with reduced spacer volume and absence of a valve being acceptable sacrifices in terms of dose delivery and ease of tidal breathing [ 30 , 34 , 35 ].…”

mentioning

confidence: 99%

A Rationale for Going Back to the Future: Use of Disposable Spacers for Pressurised Metered Dose Inhalers

Sanders

Bruin

2015

Pulmonary Medicine

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The introduction of pressurised metered dose inhalers (MDIs) in the mid-1950s completely transformed respiratory treatment. Despite decades of availability and healthcare support and development of teaching aids and devices to promote better use, poor pMDI user technique remains a persistent issue. The main pMDI user aid is the spacer/valved holding chamber (VHC) device. Spacer/chamber features (size, shape, configuration, construction material, and hygiene considerations) can vie with clinical effectiveness (to deliver the same dose as a correctly used pMDI), user convenience, cost, and accessibility. Unsurprisingly, improvised, low-cost alternatives (plastic drink bottles, paper cups, and paper towel rolls) have been pressed into seemingly effective service. A UK law change permitting schools to hold emergency inhalers and spacers has prompted a development project to design a low-cost, user-friendly, disposable, and recyclable spacer. This paper spacer requires neither preuse priming nor washing, and has demonstrated reproducible lung delivery of salbutamol sulphate pMDI, comparable to an industry-standard VHC, an alternative paperboard VHC, and pMDI alone. This new device appears to perform better than these other VHC devices at the low flow rates thought achievable by paediatric patients. The data suggest that this disposable spacer may have a place in the single-use emergency setting.

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Randomized trial of spacers in asthma

Abstract: The five spacers were equally efficacious for the delivery of bronchodilator in children with moderate persistent asthma presenting with airway obstruction.

Cited by 5 publications

References 19 publications

Spacers versus Nebulizers in Treatment of Acute Asthma A Prospective Randomized Study in Preschool Children

Spacers versus Nebulizers in Treatment of Acute Asthma A Prospective Randomized Study in Preschool Children

Comparison of the bronchodilating effects of albuterol delivered by valved vs. non‐valved spacers in pediatric asthma

A Rationale for Going Back to the Future: Use of Disposable Spacers for Pressurised Metered Dose Inhalers

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