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Aerosol inhalation from spacers and valved holding chambers requires few tidal breaths for children

André Schultz1, Timothy J Le Souëf, André Venter

  • 1School of Paediatrics and Child Health, University of Western Australia, Perth, Australia. andre.schultz@health.wa.gov.au

Pediatrics
|November 17, 2010
PubMed

Insights

For young children using salbutamol inhalers with spacers, two to three tidal breaths are sufficient for effective drug delivery. A single maximal breath does not improve medication intake with these devices.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Pharmacology

Background:

  • Inhaled medications are crucial for managing pediatric respiratory conditions.
  • Valved holding chambers (VHCs) are commonly used with metered-dose inhalers (MDIs) to improve drug delivery.
  • Optimal VHC usage in young children requires understanding breath technique and volume.

Purpose of the Study:

  • To determine the optimal number of tidal breaths for inhaling salbutamol from various VHCs in children.
  • To compare drug delivery efficiency between tidal breathing and single maximal breaths across different VHCs.

Main Methods:

  • Simulated breathing patterns of 2- to 7-year-old children using a flow generator.
  • Drug delivery was assessed from four different VHCs (Aerochamber Plus, Funhaler, Volumatic, and a modified bottle) using placebo.
  • Comparison of drug delivery with varying numbers of tidal breaths versus a single maximal breath.

Main Results:

  • Mean inhalation volumes during tidal breathing were substantial (384-445 mL).
  • Drug delivery percentages varied by VHC and breath number, with no significant improvement for a single maximal breath.
  • Two tidal breaths were effective for smaller VHCs and the modified bottle; three breaths were adequate for the larger Volumatic.

Conclusions:

  • Young children's tidal breaths generate larger-than-anticipated inhalation volumes through VHCs.
  • Two to three tidal breaths are sufficient for effective salbutamol delivery via common VHCs in pediatric patients.
  • The findings support specific breath count recommendations for VHC use in children.
Abstract

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