Comparative Efficacy of Two Inhalational Techniques when Using a Pressurized Meter Dose Inhaler with Valved Holding...

Area of Science:

• Pediatric Pulmonology
• Respiratory Medicine
• Clinical Trials

Background:

• Pressurized metered dose inhalers (pMDI) with valved holding chambers (VHC) are optimal for asthma treatment.
• Breath-holding (BH) technique is considered superior, but tidal breathing (TB) is an alternative recommended by Global Initiative for Asthma (GINA).
• Previous studies show variable results regarding lung deposition and effectiveness of BH versus TB techniques.

Purpose of the Study:

• To compare the effectiveness of the breath-holding (BH) technique versus the tidal breathing (TB) technique for inhaled medication delivery in children with asthma.
• To address limitations of previous studies and confirm scintigraphy findings on lung deposition.

Main Methods:

• A randomized controlled trial involving 82 children aged 5-14 years with nonsevere asthma.
• Participants received inhaled medications via pMDI + VHC over 8 weeks.
• Primary outcome: change in spirometry parameters at 2 and 8 weeks; secondary outcomes included asthma control.

Main Results:

• No significant intergroup differences in spirometry parameters or asthma control scores were observed between BH and TB techniques.
• A significant intragroup improvement in forced expiratory volume in the first second (FEV1) and asthma control scores was noted at 8 weeks.
• No adverse events were reported in either group.

Conclusions:

• The study found no significant difference between BH and TB techniques for pMDI + VHC delivery in children with nonsevere asthma.
• Both BH and TB techniques are suitable for children aged 5-14 years with nonsevere asthma.
• Clinical trial registration number: CTRI/2020/12/030078.