Focus
Spray con il distanziatore: istruzioni per l'uso
HOLDING CHAMBERS (SPACERS) FOR ASTHMA: DIRECTIONS FOR USE
D. Radzik
Dicembre 2007 - pagg. 637 -644
Abstract
There is clear evidence to support the use of a pressurized metered dose inhaler (pMDI)/
spacer combination in the treatment of mild to moderate acute asthma rather than a nebulizer.
With the first method there are additional benefits like fewer side effects and less time
spent in the Emergency Department; furthermore spacers are cheaper and more portable.
Nevertheless physicians, nurses, patients and their relatives seldom use this technique: reasons
for this “nebulizer culture” are briefly analyzed and useful tips of best clinical practice
on this topic are presented.
Classificazione MeSH
Bibliografia
1. Barry PW, O’Callaghan C. The optimum
size and shape of spacer devices for inhalation
therapy. J Aerosol Med 1995;8:303-5.
2. Newman SP. Principles of metered-dose inhaler design. Respir Care 2005;50(9):1177- 90.
3. Corr D, Dolovich M, McCormack D. Design and characteristics of a portable breath actuated, particle size selective medical aerosol inhaler. J Aerosol Sci 1982;13:1-7.
4. Zar HJ, Weinberg EG, Binns HJ, Gallie F, Mann MD. Lung deposition of a aerosol: a comparison of different spacers. Arch Dis Child 2000;82:495-8.
5. Zar HJ, Brown G, Donson H. Home-made spacers for bronchodilator therapy in children with acute asthma: a randomized trial. Lancet 1999;354:979-82.
6. Zar HJ, Streun S, Levin M, Weinberg EG, Swingler GH. Randomised controlled trial of the efficacy of a metered dose inhaler with bottle spacer for bronchodilator treatment in acute lower airway obstruction. Arch Dis Child 2007;92:142-6.
7. Mitchell JP. Spacers and holding chambers: not the last word we hope. Arch Dis Child 2001;84:9.
8. Global Initiative for asthma 2006. Global strategy for asthma management and prevention. NHLBI/WHO workshop. www.ginasthma. com
9. No Authors listed. Inhalation devices. CMAJ 2005;13:S39-S45.
10. Esposito-Festen JE, Ates B, van Vliet FJ, Verbraak AF. Effect of a facemask leak on aerosol delivery from a pMDI-spacer system. J Aerosol Med 2004;17:1-6.
11. Smaldone GC, Berg E, Nikander K. Variation in pediatric aerosol delivery: importance of face mask. J Aerosol Med 2005; 18(3):354-63.
12. Amirav I, Newhouse MT. Aerosol therapy with valved holding chambers in young children: importante of the facemask seal. Pediatrics 2001;108:389-94.
13. Hayden JT, Smith N. Woolf DA, Barry PW, O’Callaghan C. A randomized crossover trial of face mask efficacy. Arch Dis Child 2004;89:72-7.
14. Gleeson JG, Price JF. Nebuhaler technique. Br J Dis Chest 1988;82(2):172-4.
15. James RW, Masters IB. Single breath versus panting technique in salbutamol delivery through a 750 ml spacing device. Pediatr Pulmunol 1990;8(4):263-7.
16. Roller CM, Zhang G, Troedson RG, Leach CL, Le Souef PN. Spacer inhalation technique and deposition of extrafine aerosol in asthmatic children. Eur Resp J 2007;29:299- 306.
17. Mitchell JP, Chem C, Coppolo DP, Nagel MW. Electrostatics and inhaled medications: influence on delivery via pressurized metered- dose inhalers and add-on devices. Respire Care 2004;52:283-300.
18. Bisgaard H. A metal aerosol holding chamber devised for young children with asthma. Eur Respir J 1995;8:856.
19. Dompeling E, Oudesluys-Murphy, Janssens HM, et al. Randomised controlled study of clinical efficacy of spacer therapy in asthma with regard to electrostatic charge. Arch Dis Child 2001;84:178-82.
20. Anhoj J, Bisgaard H, Lipworth BJ. Effect of electrostatic charge in plastic spacers on the lung delivery of HFA-salbutamol in children. Br J Clin Pharmacol 1999;47(3):333-6.
21. Rau JL. Practical problems with aerosol therapy in COPD. Respire Care 2006;51(2): 158-72.
22. Chuffart AA, Sennhauser FH, Wildhaber JH. Factors affecting the efficiency of aerosol therapy with pressurised metered-dose inhalers through plastic spacers. Swiss Med Wkly 2001;131:14-8.
23. Dekker FW, Dieleman FE, Kaptei AA, Mulder JD. Compliance with pulmonary medication in general practice. Eur Respir J 1993;6:886-90.
24. Gibson NA, Ferguson AE, Aitchison TC, Paton JY. Compliance with inhaled asthma medication in preschool children. Thorax 1995;50:1274-9.
25. Celano M, Geller RJ, Phillips KM, Ziman R. Treatment adherence among low-income children with asthma. J Pediatr Psychol 1998; 23:345-9.
26. Iles R, Lister P, Edmunds AT. Crying significantly reduces absorption of aerosolized drug in infants. Arch Dis Child 1999;81:163-5
27. Watt PM, Clements B, Devadason SG, Chaney GM. Funhaler spacer: improving adherenc without compromising delivery. Arch Dis Child 2003;88:579-81.
28. Chaney G, Clements B, Landau L, Bulsara M, Watt P. A new asthma spacer device to improve compliance in children: a pilot study. Respirology 2004,9:499-506
29. Burgess SW, Sly P, Cooper DM, Devadason SG. Novel spacer device does not improve adherence in childhood asthma. Pediatr Pulmonol 2007; June 22 (Epub ahead of print).
30. Pham Ti Thuong N, Le Bourgeois M, de Blic J, Scheinmann P. Le traitement inhale en pratique. Archives de Pédiatrie 2004;11: 1377-83.
31. British Guideline on the Management of Asthma, 2005. www.sign.ac.uk.
2. Newman SP. Principles of metered-dose inhaler design. Respir Care 2005;50(9):1177- 90.
3. Corr D, Dolovich M, McCormack D. Design and characteristics of a portable breath actuated, particle size selective medical aerosol inhaler. J Aerosol Sci 1982;13:1-7.
4. Zar HJ, Weinberg EG, Binns HJ, Gallie F, Mann MD. Lung deposition of a aerosol: a comparison of different spacers. Arch Dis Child 2000;82:495-8.
5. Zar HJ, Brown G, Donson H. Home-made spacers for bronchodilator therapy in children with acute asthma: a randomized trial. Lancet 1999;354:979-82.
6. Zar HJ, Streun S, Levin M, Weinberg EG, Swingler GH. Randomised controlled trial of the efficacy of a metered dose inhaler with bottle spacer for bronchodilator treatment in acute lower airway obstruction. Arch Dis Child 2007;92:142-6.
7. Mitchell JP. Spacers and holding chambers: not the last word we hope. Arch Dis Child 2001;84:9.
8. Global Initiative for asthma 2006. Global strategy for asthma management and prevention. NHLBI/WHO workshop. www.ginasthma. com
9. No Authors listed. Inhalation devices. CMAJ 2005;13:S39-S45.
10. Esposito-Festen JE, Ates B, van Vliet FJ, Verbraak AF. Effect of a facemask leak on aerosol delivery from a pMDI-spacer system. J Aerosol Med 2004;17:1-6.
11. Smaldone GC, Berg E, Nikander K. Variation in pediatric aerosol delivery: importance of face mask. J Aerosol Med 2005; 18(3):354-63.
12. Amirav I, Newhouse MT. Aerosol therapy with valved holding chambers in young children: importante of the facemask seal. Pediatrics 2001;108:389-94.
13. Hayden JT, Smith N. Woolf DA, Barry PW, O’Callaghan C. A randomized crossover trial of face mask efficacy. Arch Dis Child 2004;89:72-7.
14. Gleeson JG, Price JF. Nebuhaler technique. Br J Dis Chest 1988;82(2):172-4.
15. James RW, Masters IB. Single breath versus panting technique in salbutamol delivery through a 750 ml spacing device. Pediatr Pulmunol 1990;8(4):263-7.
16. Roller CM, Zhang G, Troedson RG, Leach CL, Le Souef PN. Spacer inhalation technique and deposition of extrafine aerosol in asthmatic children. Eur Resp J 2007;29:299- 306.
17. Mitchell JP, Chem C, Coppolo DP, Nagel MW. Electrostatics and inhaled medications: influence on delivery via pressurized metered- dose inhalers and add-on devices. Respire Care 2004;52:283-300.
18. Bisgaard H. A metal aerosol holding chamber devised for young children with asthma. Eur Respir J 1995;8:856.
19. Dompeling E, Oudesluys-Murphy, Janssens HM, et al. Randomised controlled study of clinical efficacy of spacer therapy in asthma with regard to electrostatic charge. Arch Dis Child 2001;84:178-82.
20. Anhoj J, Bisgaard H, Lipworth BJ. Effect of electrostatic charge in plastic spacers on the lung delivery of HFA-salbutamol in children. Br J Clin Pharmacol 1999;47(3):333-6.
21. Rau JL. Practical problems with aerosol therapy in COPD. Respire Care 2006;51(2): 158-72.
22. Chuffart AA, Sennhauser FH, Wildhaber JH. Factors affecting the efficiency of aerosol therapy with pressurised metered-dose inhalers through plastic spacers. Swiss Med Wkly 2001;131:14-8.
23. Dekker FW, Dieleman FE, Kaptei AA, Mulder JD. Compliance with pulmonary medication in general practice. Eur Respir J 1993;6:886-90.
24. Gibson NA, Ferguson AE, Aitchison TC, Paton JY. Compliance with inhaled asthma medication in preschool children. Thorax 1995;50:1274-9.
25. Celano M, Geller RJ, Phillips KM, Ziman R. Treatment adherence among low-income children with asthma. J Pediatr Psychol 1998; 23:345-9.
26. Iles R, Lister P, Edmunds AT. Crying significantly reduces absorption of aerosolized drug in infants. Arch Dis Child 1999;81:163-5
27. Watt PM, Clements B, Devadason SG, Chaney GM. Funhaler spacer: improving adherenc without compromising delivery. Arch Dis Child 2003;88:579-81.
28. Chaney G, Clements B, Landau L, Bulsara M, Watt P. A new asthma spacer device to improve compliance in children: a pilot study. Respirology 2004,9:499-506
29. Burgess SW, Sly P, Cooper DM, Devadason SG. Novel spacer device does not improve adherence in childhood asthma. Pediatr Pulmonol 2007; June 22 (Epub ahead of print).
30. Pham Ti Thuong N, Le Bourgeois M, de Blic J, Scheinmann P. Le traitement inhale en pratique. Archives de Pédiatrie 2004;11: 1377-83.
31. British Guideline on the Management of Asthma, 2005. www.sign.ac.uk.
Corrispondenza: dradzik@alice.it