Emergency-use spacers: a considerable option for asthmatic patients

Area of Science:

• Respiratory medicine
• Pharmacology
• Medical device engineering

Background:

• Pressurized metered dose inhalers (pMDIs) are crucial for asthma management.
• Spacers improve pMDI efficacy by mitigating hand-breath coordination challenges.

Purpose of the Study:

• To evaluate and compare the effectiveness of emergency-use and conventional pMDI spacers.
• To assess the impact of spacer design on salbutamol delivery and absorption.

Main Methods:

• A randomized trial involving 108 asthmatics across 9 groups (pMDI alone and various spacers).
• Quantified emitted dose via high-performance liquid chromatography on ex vivo filters.
• Assessed pulmonary absorption using urinary salbutamol (USAL0.5) and spirometry (FEV₁, FVC).

Main Results:

• pMDI alone had highest ex vivo deposition but lowest pulmonary absorption and bronchodilation.
• Aerochamber, Able, and Tips-Haler spacers demonstrated superior performance in ex vivo deposition, absorption, and FEV₁ improvement.
• DispozABLE and Lite-Air showed moderate efficacy, while Atomizer had the lowest pulmonary function performance.

Conclusions:

• Spacer design significantly influences pMDI efficacy.
• Validated emergency-use spacers are recommended for low-resource or emergency settings.
• The study supports the clinical utility of specific spacer devices in asthma care.