Comparison of efficiency and preference of metal and plastic spacers in preschool children.
BACKGROUND
The metal NebuChamber valved holding chamber (VHC) has gained wide acceptance among children with asthma. Due to its nonelectrostatic properties and larger volume, the 250-mL, metal NebuChamber delivers a greater mass of aerosol to a filter at the mouth compared with the commonly used 150-mL polypropylene AeroChamber VHC. Such in vitro results have been used to suggest that this may provide increased efficacy with the NebuChamber. No comparative efficacy data exist for preschool children with asthma.


OBJECTIVE
To compare efficiency and preference of metal and plastic spacers in preschool children.


METHODS
Children with mild-to-moderate persistent asthma received 200 microg of budesonide twice daily by NebuChamber or AeroChamber, both with the mask provided in a randomized, 2-month, crossover trial. Symptom diary cards, beta-agonist use, and preference by children and parents were compared.


RESULTS
Thirty children (mean +/- SD age, 4.3 +/- 0.3 years) completed the study. There was no difference between the AeroChamber and NebuChamber in clinical efficacy outcomes. There was no difference between the AeroChamber and NebuChamber in parents' view of ease of use, design, acceptability by the children, and overall satisfaction.


CONCLUSIONS
Despite a greater total dose delivered to the mouth, the NebuChamber appears no more effective than the AeroChamber and it is not preferred by patients or parents. More parents chose to continue to use the NebuChamber after the study.
Sieff Hospital Safed, Safed, Rosha Pina, Israel. amirav@012.net.il
I
I
Amirav
T
T
Tiosano
S
S
Chamny
S
S
Chirurg
S
S
Oren
Z
Z
Grossman
E
E
Kahan
M T
MT
Newhouse
Y
Y
Mansour
D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000627:therapeutic use; D000336:Aerosols; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy / Q000523:psychology*; D019819:Budesonide / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D004359:Drug Therapy, Combination; D004867:Equipment Design; D005260:Female; D006801:Humans; D036503:Inhalation Spacers; D008297:Male; D036501:Metered Dose Inhalers; D010290:Parents / Q000523:psychology; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D011126:Polypropylenes; D013193:Stainless Steel; D016896:Treatment Outcome
D000318:Adrenergic beta-Agonists; D000336:Aerosols; D018927:Anti-Asthmatic Agents; D011126:Polypropylenes; D013193:Stainless Steel; D019819:Budesonide