- Metered-dose inhaler therapy with spacers: Are newborns capable of using this system correctly? [Journal Article]
- PPPediatr Pulmonol 2019 Jul 08
- CONCLUSIONS: In neonates, the MDI therapy with a spacer chamber and face mask is susceptible to failure due to the inability of most patients in this age range to generate a negative inspiratory pressure sufficient to open the spacer valve.
- Effects of flow rate on transnasal pulmonary aerosol delivery of bronchodilators via high-flow nasal cannula for patients with COPD and asthma: protocol for a randomised controlled trial. [Journal Article]
- BOBMJ Open 2019 Jun 24; 9(6):e028584
- Both in vitro and in vivo radiolabelled studies on nebulisation via high-flow nasal cannula showed that inhaled dose decreases as the administered gas flow increases. In our previous in vitro study, …
Both in vitro and in vivo radiolabelled studies on nebulisation via high-flow nasal cannula showed that inhaled dose decreases as the administered gas flow increases. In our previous in vitro study, we investigated the effects of the ratio of gas flow to subject's peak inspiratory flow (GF:IF) on the aerosol deposition, which increased as the GF:IF decreased, with an optimal GF:IF between 0.1 and 0.5 producing a stable 'lung' deposition in both quiet and distressed breathing. Thus, we aim to validate our in vitro findings in subjects with reversible airflow limitations by assessing their response to inhaled bronchodilator.
- Bioavailability of Beclometasone From Two HFA-BDP Formulations With a Spacer. [Journal Article]
- RCRespir Care 2019 May 28
- CONCLUSIONS: The difference in the BDP particle size between formulations as well as spacer size greatly affected drug deposition in different regions of the respiratory tract.
- Valved holding chamber drug delivery is dependent on breathing pattern and device design. [Journal Article]
- EOERJ Open Res 2019; 5(1)
- Small children with airway obstruction breathe with very low tidal volumes (VT) and high respiratory rates (RRs). These extreme respiratory patterns affect drug delivery unpredictably through valved …
Small children with airway obstruction breathe with very low tidal volumes (VT) and high respiratory rates (RRs). These extreme respiratory patterns affect drug delivery unpredictably through valved holding chambers (VHCs). We compared in an in vitro study the effectiveness of two VHCs, one small (140 mL, Optichamber Diamond) and one large (350 mL, Babyhaler) without facemasks, to deliver salbutamol to filters positioned between the VHC mouthpieces and a breathing simulator. Different tidal volumes (from 30 mL to 200 mL) and RRs (25·min-1 and 50·min-1) were applied through a breathing simulator. The amount of salbutamol delivered increased with increasing VT in both VHCs for both RRs (ρ>0.87 and p<0.001 for both devices at both rates). The effect of RR was not as evident, but drug delivery tended to be higher at the higher rate. Drug delivery was significantly higher through the Optichamber Diamond as compared with the Babyhaler at every combination of RR and VT up to a 12-fold difference. We found marked differences in salbutamol delivery between the Babyhaler and Optichamber Diamond VHCs. The delivered dose of salbutamol increased with increasing VT and RR with both VHCs but with differences related to valve dead spaces. Instead of considering all VHCs equal in clinical paediatric practice, each device should be tested in vitro with respiratory patterns relevant to small children with respiratory difficulties.
- Salbutamol and ipratropium by inhaler is superior to nebulizer in children with severe acute asthma exacerbation: Randomized clinical trial. [Journal Article]
- PPPediatr Pulmonol 2019; 54(4):372-377
- CONCLUSIONS: Even in severe asthma exacerbations administration of salbutamol and ipratropium by MDI with valved-holding chamber and mask along with oxygen by a cannula separately was more effective than by a nebulizer.
- Usefulness of Nonvalved Spacers for Administration of Inhaled Steroids in Young Children with Recurrent Wheezing and Risk Factors for Asthma. [Randomized Controlled Trial]
- CRCan Respir J 2018; 2018:3095647
- CONCLUSIONS: Long-term treatment with inhaled steroids administered by MDI and NVS is less effective than such treatment by MDI and VHC in infants with recurrent wheezing and risk factors for asthma.
- Efficient Nose-to-Lung Aerosol Delivery with an Inline DPI Requiring Low Actuation Air Volume. [Journal Article]
- PRPharm Res 2018 Aug 21; 35(10):194
- CONCLUSIONS: The optimized LV-DPI system is capable of high efficiency lung delivery of powder aerosols through a challenging nasal cannula interface.
- Effect of a spacer on total systemic and lung bioavailability in healthy volunteers and in vitro performance of the Symbicort® (budesonide/formoterol) pressurized metered dose inhaler. [Randomized Controlled Trial]
- PPPulm Pharmacol Ther 2018; 52:7-17
- CONCLUSIONS: The clinical study demonstrated that in subjects with poor inhalation technique the use of the AeroChamber Plus® Flow-Vu® spacer increased the bioavailability of Symbicort® pMDI to a level observed in subjects with good inhalation technique without a spacer. The findings from the in vitro study support the fine particle dose characteristics of Symbicort® pMDI with the AeroChamber Plus® Flow-Vu® spacer.
- Spacer devices for inhaled therapy: why use them, and how? [Review]
- EOERJ Open Res 2018; 4(2)
- We present an extensive review of the literature to date pertaining to the rationale for using a spacer/valved holding chamber (VHC) to deliver inhaled therapy from a pressurised, metered-dose inhale…
We present an extensive review of the literature to date pertaining to the rationale for using a spacer/valved holding chamber (VHC) to deliver inhaled therapy from a pressurised, metered-dose inhaler, a discussion of how the properties of individual devices may vary according to their physical characteristics and materials of manufacture, the potential risks and benefits of ancillaries such as valves, and the evidence that they contribute tangibly to the delivery of therapy. We also reiterate practical recommendations for the correct usage and maintenance of spacers/VHCs, which we trust offer practical help and advice to patients and healthcare professionals alike.
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- Cartoons to improve young children's cooperation with inhaled corticosteroids: A preliminary study. [Journal Article]
- PPPediatr Pulmonol 2018; 53(9):1193-1199
- CONCLUSIONS: Bad cooperation among young children with asthma during the delivery of their treatment can be dramatically improved by the use of animated cartoons.