Academic Journal
Emergency-use spacers: a considerable option for asthmatic patients.
| Τίτλος: | Emergency-use spacers: a considerable option for asthmatic patients. |
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| Συγγραφείς: | Sayed OA; Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt. Electronic address: OmarAhmed@pharm.bsu.edu.eg., Laz NI; Chest Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt., Abdelrahim ME; Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt., Saeed H; Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt; Clinical Pharmacy Department, Faculty of Pharmacy, King Salman International University (KSIU), South Sinai, Egypt. |
| Πηγή: | Heart & lung : the journal of critical care [Heart Lung] 2026 May-Jun; Vol. 77, pp. 102719. Date of Electronic Publication: 2026 Jan 02. |
| Τύπος έκδοσης: | Journal Article; Randomized Controlled Trial |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Mosby Country of Publication: United States NLM ID: 0330057 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-3288 (Electronic) Linking ISSN: 01479563 NLM ISO Abbreviation: Heart Lung Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: St. Louis, Mosby. |
| Ιατρικοί όροι (MeSH): | Asthma*/drug therapy , Asthma*/physiopathology , Albuterol*/administration & dosage , Bronchodilator Agents*/administration & dosage , Metered Dose Inhalers* , Inhalation Spacers*, Humans ; Male ; Female ; Adult ; Middle Aged ; Administration, Inhalation ; Equipment Design ; Forced Expiratory Volume ; Spirometry |
| Περίληψη: | Background: Pressurized metered dose inhalers (pMDIs) spacers improve delivery by reducing hand-breath coordination requirements. Objectives: This study aimed to assess the efficacy of emergency-use and conventional spacers. Method: a multi-arm, parallel-group, randomized trial in which 108 asthmatics were randomized to 9 groups (pMDI alone and various spacers); each received 400 µg salbutamol. Emitted dose on the ex vivo filter was quantified using high-performance liquid chromatography. Pulmonary absorption was assessed via urinary salbutamol at 0.5 h post-dose (USAL0.5) and spirometry changes was assessed via forced expiratory volume in 1 second (FEV₁) and its percent of predicted (∆FEV₁ and ∆FEV₁% predicted), and forced vital capacity (∆FVC). Results: While the pMDI alone group yielded the highest ex vivo deposition (325.4 µg, P ˂0.001), it showed the lowest USAL0.5 (4.13 µg, P ˂0.001-0.032) and ∆FEV₁ (0.12 L, P ˂0.001). Among all tested devices, the Aerochamber, Able, and Tips-Haler spacers demonstrated superior performance (ex vivo filter: 207.1, 181.1, 167.5 µg, P ˂0.001-0.02; USAL0.5: 11.61, 11.15, 10.73 µg, P ˂0.001-0.09), ∆FEV₁: 0.32, 0.29, 0.31 L, respectively, P ˂0.001-0.06), with no significant difference between the three spacers, except the Aerochamber showed a significantly higher ex vivo result (P ˂0.001-0.02). DispozABLE and Lite-Air showed moderate efficacy, whereas the Atomizer, showed the lowest pulmonary function performance with varied significance across devices. Conclusion: This study emphasizes the significance of spacer design. It supports the use of validated emergency-use spacers in low-resource or emergency settings where conventional devices are not available. The trial was registered at ClinicalTrials.gov, identifier: NCT06816342. (Copyright © 2025 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors have no financial or personal competing interests related to this work. |
| Contributed Indexing: | Keywords: Aerosol delivery; Asthma; Emergency-use spacers; Pressurized metered dose inhaler; Valved holding chambers |
| Molecular Sequence: | ClinicalTrials.gov NCT06816342 |
| Substance Nomenclature: | QF8SVZ843E (Albuterol) 0 (Bronchodilator Agents) |
| Entry Date(s): | Date Created: 20260103 Date Completed: 20260423 Latest Revision: 20260901 |
| Update Code: | 20260901 |
| DOI: | 10.1016/j.hrtlng.2025.102719 |
| PMID: | 41483541 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1527-3288 |
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| DOI: | 10.1016/j.hrtlng.2025.102719 |