Respuesta broncodilatadora del salbutamol administrado como aerosol presurizado mediante aerocámaras con válvulas o espaciadores no valvulados

Abstract

Introduction. Inhalation therapy is the most frequent route for administration of asthma treatment. The utility of spacers added to metered dose inhalers (MDI) is well established. However, non-valved spacers have recently been proposed as equally effective as the valved holding chambers, and more cost-effective. Clinical efficacy of non-valved spacers is not well established yet. Objective. To compare the bronchodilator response to albuterol administered by MDI with a valved holding chamber vs. a non-valved spacer. Population, materials and methods. In an experimental, prospective, randomized, simple blind, parallel group study, 34 asthmatic children from 6 to 16 years old, with mild or moderate bronchial obstruction (forced expiratory volume in the first second, FEV1, 50 to 79% of predicted) without recent treatment with bronchodilating agents were randomly assigned to be treated with 100 µg of albuterol MDI (Ventolin TM, MDI) either through a valved (AerochamberTM) or a non-valved (AeromedTM) spacer. After 30 minutes, bronchodilating response was determined through FEV1 and FMF measurements. Results. 17 patients used the valved holding chamber (12 male, baseline FEV1 67 ± 10%) and 17, the non-valved spacer (13 male, baseline FEV1 67 ± 6%). Variation of FEV1 was 26 ± 14% and 16±5% (p= 0.017) and variation of forced medium flow (FMF) was 92 ± 48% and 58 ± 29% (p< 0.018) for the valved holding chamber and for the non-valved spacer, respectively (ANOVA test). Conclusion. Albuterol administered by MDI through a valved spacer produced a greater bronchodilator response than through a non-valved spacer in asthmatic children.