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Comparison between traditional and nontraditional add-on devices used with pressurised metered-dose inhalers

Mina Nicola, Youssef M.A. Soliman, Raghda Hussein, Haitham Saeed, Mohamed Abdelrahim
ERJ Open Research 2020 6: 00073-2020; DOI: 10.1183/23120541.00073-2020
Mina Nicola
1Dept of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
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Youssef M.A. Soliman
2Dept of Chest Diseases, Faculty of Medicine, Cairo University, Cairo, Egypt
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Raghda Hussein
1Dept of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
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Haitham Saeed
1Dept of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
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Mohamed Abdelrahim
1Dept of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
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  • ORCID record for Mohamed Abdelrahim
  • For correspondence: mohamedemam9@yahoo.com
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  • FIGURE 1
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    FIGURE 1

    The five devices and valved holding chambers used in the study: a) Tips-haler spacer; b) Dolphin chamber; c) homemade spacer from a water bottle; d) Aerochamber plus flow Vu chamber; e) Able spacer.

  • FIGURE 2
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    FIGURE 2

    Schematic diagram illustrating the measurement of total inhalable dose using a)metered-dose inhaler (MDI) alone, b) MDI with mouthpiece spacer and c) MDI with facemask spacer.

Tables

  • Figures
  • TABLE 1

    Outcome of salbutamol dose delivered via metered-dose inhaler (MDI) and different MDI–spacer combinations in 4 L volume of inhalation (assuming adult inhalation volume)

    MDI or MDI/accessory deviceNatureEmitted dose %Dose deposited in spacer %
    MDI only86.8 ± 5.1NA
    Aerochamber mouthpieceAntistatic71.6 ± 4.416.8 ± 3.30
    Aerochamber maskAntistatic69.7 ± 5.418.9 ± 4.9
    Able spacer mouthpieceAntistatic64.2 ± 6.923.2 ± 4.3
    Able spacer maskAntistatic61.2 ± 6.624.1 ± 4.9
    Tips-haler mouthpieceAntistatic53.6 ± 7.234.4 ± 7.4
    Tips-haler maskAntistatic51.3 ± 4.734.6 ± 5.8
    Dolphin chamber mouthpieceNon-antistatic31.9 ± 5.456 ± 4.7
    Dolphin chamber maskNon-antistatic30.5 ± 5.655.2 ± 9.7
    Dolphin chamber washNon-antistatic49.7 ± 6.4NA
    Drink bottle mouthpieceNon-antistatic35.3 ± 6.950.2 ± 4.3
    Drink bottle washNon-antistatic51.2 ± 7.1NA

    Data are presented as mean±sd. NA: not applicable.

    • TABLE 2

      Outcome of salbutamol dose delivered via metered-dose inhaler (MDI) and different MDI–spacer combinations in 2 L volume of inhalation (assuming old child inhalation volume)

      MDI or MDI/accessory deviceNatureEmitted dose %Dose deposited in spacer %
      MDI only87.2 ± 6.9NA
      Aerochamber maskAntistatic69.8 ± 5.818.7 ± 4.1
      Able spacer mouthpieceAntistatic66.2 ± 622.3 ± 4.3
      Able spacer maskAntistatic64.3 ± 5.124.1 ± 4.9
      Tips-haler mouthpieceAntistatic53.9 ± 6.538.2 ± 4.5
      Tips-haler maskAntistatic51.5 ± 6.134.5 ± 6
      Dolphin chamber mouthpieceNon-antistatic32.4 ± 6.753.7 ± 5.5
      Dolphin chamber maskNon-antistatic32.2 ± 6.457.6 ± 3.5
      Dolphin chamber washNon-antistatic47.6 ± 5.9NA
      Drink bottle mouthpieceNon-antistatic34.3 ± 7.354 ± 9.3
      Drink bottle washNon-antistatic49.9 ± 6.2NA

      Data are presented as mean±sd. NA: not applicable.

      • TABLE 3

        Outcome of salbutamol dose delivered via metered-dose inhaler (MDI) and different MDI–spacer combinations in 1 L volume of inhalation (assuming young child inhalation volume)

        MDI or MDI/accessory deviceNatureEmitted dose %Dose deposited in spacer %
        MDI only84.1 ± 6NA
        Aerochamber maskAntistatic58.3 ± 6.530.1 ± 6.9
        Able spacer maskAntistatic55.6 ± 6.331.6 ± 4.2
        Tips-haler maskAntistatic46.4 ± 5.838.3 ± 9.8

        Data are presented as mean±sd. NA: not applicable.

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        Comparison between traditional and nontraditional add-on devices used with pressurised metered-dose inhalers
        Mina Nicola, Youssef M.A. Soliman, Raghda Hussein, Haitham Saeed, Mohamed Abdelrahim
        ERJ Open Research Oct 2020, 6 (4) 00073-2020; DOI: 10.1183/23120541.00073-2020

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        Comparison between traditional and nontraditional add-on devices used with pressurised metered-dose inhalers
        Mina Nicola, Youssef M.A. Soliman, Raghda Hussein, Haitham Saeed, Mohamed Abdelrahim
        ERJ Open Research Oct 2020, 6 (4) 00073-2020; DOI: 10.1183/23120541.00073-2020
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