Randomized trial of spacers in asthma.
OBJECTIVE
To compare the efficacy of all types of spacers commonly available to children in India.


METHODS
150 children 5-14 yr of age with persistent asthma presenting with peak expiratory flow (PEF) < 70% of personal best were randomized to receive 200 mg salbutamol through one of five spacers: A) 750 ml spacer with valve, B) 165 ml spacer with valve, C) 250 ml spacer without valve, D) 1000 ml indigenously made spacer without valve and E) 500 ml indigenously made spacer without valve. PEF measurement was repeated 15 minutes later. Children> 8 yr old performed spirometry in addition to PEF. Absolute change and percentage improvement of PEF and FEV1 were compared among the groups.


RESULTS
Subjects in all groups had comparable baseline demographic characteristics and PEF. All showed significant improvement in PEF and FEV1 over baseline values. The change in PEF and percentage improvement were comparable among all five groups (p=0.780 and p=0.955 respectively). Likewise change in FEV1 and percentage improvement were also comparable. The five groups showed no difference in efficacy, irrespective of severity of baseline airway obstruction.


CONCLUSIONS
The five spacers were equally efficacious for the delivery of bronchodilator in children with moderate persistent asthma presenting with airway obstruction.
Dahiya
Baljit
B
Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. meenusingh4@rediffmail.com.
Mathew
Joseph L
JL
Singh
Meenu
M
D000293:Adolescent; D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage*; D000420:Albuterol / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D036503:Inhalation Spacers; D008297:Male; D036501:Metered Dose Inhalers; D010366:Peak Expiratory Flow Rate
D000316:Adrenergic alpha-Agonists; D001993:Bronchodilator Agents; D000420:Albuterol
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