Incorrect use of a homemade spacer for treatment of recurrent wheezing in children - a cause for concern
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2005
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South African Medical Journal
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University of Cape Town
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Abstract
Inhaled bronchodilators, particularly β2-agonists, are one of the most effective therapies for rapid reversal of airway narrowing in acute asthma. In children bronchodilators are best given using a metered dose inhaler (MDI) with attached spacer; this is as effective as nebulised therapy, with fewer side-effects. 1,2
However, a spacer must be used with a MDI as children are unable to synchronise inspiration with actuation of the MDI nor can they breath hold at the end of inspiration, particularly when there is lower airways obstruction as occurs during an acute asthma attack.1,2 A modified 500 ml plastic bottle spacer has been found to be as effective as a conventional smallvolume spacer for delivery of bronchodilators in children with
acute wheezing.3-5 In contrast, a cup has been shown to be a very poor spacer, with poor efficacy when used for giving bronchodilators in the treatment of acute asthma.3-5
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Reference:
Zar, H. J., Motala, C., & Weinberg, E. (2005). Incorrect use of a homemade spacer for treatment of recurrent wheezing in children–a cause for concern. South African Medical Journal, 95(6), 388-390.