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|Evaluation of the new model of spacer "L'Espace" in asthmatic children||
Campana G., Allegorico A., Coronella A., Galdo F., Indolfi C., Miraglia Del Giudice M.
Metered-dose inhaler (MDI) represent the most practical and cheap way to deliver inhaled medication in the treatment of bronchial asthma (1) . There are, however, two main issues related to their use: the high speed dispensing, which causes the deposition of the most of the dose on the mouth and the need for a perfect coordination between dispensing and inhalation.
The spacers are devices that are used between MDI and the patient's mouth. In this manner the drug is delivered into the spacer and then inhaled by the patient in order to reduce the coordination problems. Furthermore the spacers are able to reduce the speed and the diameter of the drug particles reducing oro-pharyngeal deposition and increasing the amount of particles in respirable range (2, 3) . All of these benefits are especially useful in children. International guidelines suggest the use of spacers with a mask in children under the age of 4 years (4) . However this is a relative age limitation; the mask is recommended since the child is able to use a device with a mouth-piece.
All the children and their parents returned after seven days. About the first point, that is the comfort of the new spacer, 2 parents assigned a score between 3 and 4, 4 parents have assigned a score of 4, and 5 parents a score between 4 and 5 (with an arithmetic mean of the overall 4.2) (see Fig. 1.A) . About the adherence to the face of the new device, 4 parents assigned a score of 4, 8 and parents a score between 4 and 5 (with an arithmetic average overall of 4.5) (see Fig. 1.B) . About the valves motion, 6 parents assigned a score between 3 and 4, and 6 parents a score between 4 and 5 (with an arithmetic mean of the overall 4) (see Fig. 1.C) . About the effectiveness of the new ”L ' Espace” in comparison to the spacer usually used, 3 parents assigned a score between 3 and 4, and 9 parents a score between 4 and 5 (with an arithmetic mean of the overall 4.5) (see Fig. 1.D) . About the overall judgment on the new "L'Espace", 4 parents have assigned a score between 4 and 5, and 8 parents a rating of 5 (with an arithmetic average overall of 4.8) (see Fig. 1.E) .
This study shows that by using a visual analog scale from 0 to 5, the new spacer "L'Espace" presents an overall score higher than 4, and is more comfortable and effective than the spacers normally used in the selected families.
1. O’Callaghan C, Barry P. Spacer devices in thetreatment of asthma. BMJ 1997; 314: 1061-1062.
2. Newman SP. Principles of metered-dose inhaler design. Respir Care 2005;50:1177-90.
3. Lavorini F, Fontana GA Targeting drugs to the airways: The role of spacer devices.
Expert Opin Drug Deliv. 2009 Jan;6 (1):91-102
4. Global Initiative for Asthma 2015. The GINA asthma strategy report: what's new for primary care? www.ginasthma.com.
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|www.thechild.it Four-monthly Journal of Pediatrics edited by Genetics and Pediatric Association (APIG)
Law March 7th, 2001, n. 62 - Press Register Court of Messina n. 4/2012
Director manager: Giuseppe Micali - Scientific manager: Giorgio Ciprandi - Editor in chief: Carmelo Salpietro
Secretariat writing: Basilia Piraino - Piera Vicchio - Italia Loddo
Editorial staff from Genetics and Pediatric Unit - University of Messina