Lung deposition of aerosol--a comparison of different spacers.
OBJECTIVE
To investigate (1) aerosol lung deposition obtained from two small volume conventional spacers (Babyhaler and Aerochamber) and a home made spacer (modified 500 ml plastic cold drink bottle); (2) the effect of using a face mask or mouthpiece; and (3) the relation between age and pulmonary deposition.


METHODS
Lung deposition of aerosolised technetium-99m DTPA inhaled via spacer was measured in 40 children aged 3-7 years with stable asthma. Each patient performed sequential randomly assigned inhalations using two spacers. Three studies were performed: Babyhaler compared to Aerochamber (with facemasks); Babyhaler with facemask compared to Babyhaler with mouthpiece; and Babyhaler with mouthpiece compared to a 500 ml bottle.


RESULTS
Median lung aerosol deposition from a Babyhaler and Aerochamber with masks were similar (25% v 21%, p = 0.9). Aerosol lung deposition from a Babyhaler with mask compared to a Babyhaler with mouthpiece was equivalent (26% v 26%, p = 0.5). Lung deposition was higher from a 500 ml bottle compared to a Babyhaler in both young (25% v 12.5%, p = 0.005) and older children (42% v 22.5%, p = 0.003). A notable reduction in pulmonary deposition occurred at 50 months of age.


CONCLUSIONS
A Babyhaler or Aerochamber produce equivalent lung deposition of aerosol. There is no difference in lung deposition when a mask or mouthpiece is used. A modified 500 ml plastic bottle produces greater pulmonary aerosol deposition than a conventional small volume spacer.
Zar
H J
HJ
Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa. heather@rmh.uct.ac.za
Weinberg
E G
EG
Binns
H J
HJ
Gallie
F
F
Mann
M D
MD
D000280:Administration, Inhalation; D000336:Aerosols / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D016503:Drug Delivery Systems / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008168:Lung / Q000737:chemistry; D008297:Male; D009330:Nebulizers and Vaporizers
D000336:Aerosols