Randomised controlled trial of the efficacy of a metered dose inhaler with bottle spacer for bronchodilator treatment in acute lower airway obstruction

Zar, H. J.; Streun, S.; Levin, M.; Weinberg, E. G.; Swungler, G. H.
February 2007
Archives of Disease in Childhood;Feb2007, Vol. 92 Issue 2, p142
Academic Journal
Background: Inhaled bronchodilator treatment given via a metered dose inhaler (MDI) and spacer is optimal for relief of bronchoconstriction. Conventional spacers are expensive or unavailable in developing countries, but there is little information on the efficacy of low-cost spacers in young children. Objective: To compare the response to bronchodilator treatment given via a conventional or a low-cost bottle spacer Methods: A randomised controlled trial of the efficacy of a conventional spacer compared with a bottle spacer for bronchodilator treatment in young children with acute lower airway obstruction. Bronchodilator treatment was given from an MDI via an Aerochamber or a bottle spacer. Clinical score and oximetry recording were carried out before and after 15 mm of treatment. MDI-spacer treatment was repeated up to three times, depending on clinical response, after which nebulisation was used. The primary outcome was hospitalisation. Results: 400 children, aged (median (25th-75th centile)) 1 2 (6-25) months, were enrolled. The number of children hospitalised (n = 60, 15%) was identical in the conventional and bottle spacer groups (n = 30, 15% in each). Secondary outcomes including change in clinical score (-2 (-3 to -1)), oxygen saturation (0 (-1 to 1)) and number of bronchodilator treatments (2 (1 to 3)) were similar in both groups. Oral corticosteroids, prescribed for 78 (19.5%) children, were given to a similar number in the conventional (37 (18.5%)) and bottle spacer groups (41 (20.5%)). Conclusion: A low-cost bottle spacer is as effective as a conventional spacer for bronchodilator treatment in young children with acute obstruction of the lower airways.


Related Articles

  • Effect of inspiratory flow rate on β2-agonist induced bronchodilation in mechanically ventilated COPD patients. Mouloudi, E.; Prinianakis, G.; Kondili, E.; Georgopoulos, D. // Intensive Care Medicine;Jan2001, Vol. 27 Issue 1, p42 

    Objectives: To test the effect of two different inspiratory flow rates on the bronchodilation induced by β2-agonists administered by metered dose inhaler (MDI). Patients: Ten patients with acute exacerbation of chronic obstructive pulmonary disease and receiving mechanical ventilation with...

  • Inhalers and Spacers.  // Pediatrics for Parents;2004, Vol. 21 Issue 2, p10 

    Provides information on the use of metered-dose inhalers (MDI) for treating children with asthma in the U.S. Instructions for the proper use of the MDI with spacers; Problems children have with using the MDI; Efficiency of delivering the medication with the use of MDI.

  • Simple instructions for using pressurized aerosol bronchodilators. Newman, Stephen P.; Pavia, Demetri; Clarke, Stewart W. // Journal of the Royal Society of Medicine;Nov1980, Vol. 73 Issue 11, p776 

    Although the manufacturers of pressurized aerosol bonchodilators issue instructions for using the inhalers, little or no experimental verification exists. Bronchodilatation has been measured after controlled inhalations of 500 μg terbutaline sulphate given in a systematic series of...

  • Knowledge Limited for Accurately Measuring Contents of Metered Dose Inhalers. Spellman, Marguerite // Pulmonary Reviews;Aug2008, Vol. 13 Issue 8, p19 

    The article discusses research being done on the measurement of the contents of a metered dose inhaler (MDI). It references a study presented at the American Thoracic Society's 104th International Conference. Researchers found that neither providers nor patients have knowledge in determining the...

  • Dose Counting in Metered Dose Inhalers.  // Medical Device Technology;Jun2006, Vol. 17 Issue 5, p52 

    The article discusses the benefits and risks on the use of pressurized metered dose inhalers (pMDI). PMDIs are the preferred drug delivery device for the treatment of asthma and chronic obstructive pulmonary disease. They are low cost, convenient, reliable and offer accurate dosing. However,...

  • The Future of Metered-Dose Inhalers. Pritchard, John // Pharmaceutical Technology Europe;Sep2005, Vol. 17 Issue 9, p22 

    Advances in pressurized metered-dose inhalers (pMDIs) in terms of formulation capability and the performance of the container closure system enable products to be developed faster and with less technical risk. Despite new delivery devices for new molecules breaking into the pMDI market, pMDIs...

  • INHALER THERAPY FOR OBSTRUCTIVE AIRWAY DISEASE.  // Journal of the Nepal Medical Association;Jul/Aug2004, Vol. 43 Issue 154, p1 

    Presents information on the effectiveness of inhaler therapy for chronic obstructive pulmonary disease (COPD). Varieties of inhalers for the treatment of COPD; Benefits of metered dose inhaler (MDI); Precautions in using MDI.

  • K-Haler asthma inhaler.  // Medeconomics;Jan2004, Vol. 25 Issue 1, p22 

    K-Haler, a low-cost inhaler that helps asthma patients by coordinating inhalation with drug release has won Best Business Proposition in the Medical Futures Innovation Awards. K-Haler is designed by pharmacist John Bell and mechanical engineer and clinical scientist Dr. Ray Bacon. It was created...

  • Pulmonary Route As An Important Means of Drug Delivery: Inhalers Provided To Meet Our Needs. Shivanand, Pandey; Vasanti, Choudhary; Mahalaxmi, R.; Viral, Devmurari; Jivani, N. P. // Journal of Pharmacy Research;Aug2009, Vol. 2 Issue 8, p1232 

    Inhalers are designed to disperse fine, respirable powders in a reproducible fashion for optimal systemic or local lung delivery. Together with our particle technologies, they create an integrated pulmonary delivery system. We also offer expertise in systems integration of pulmonary therapeutics...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics