Purpose of the Study. Plastic spacer devices may have an electrostatic charge causing aerosol to precipitate on the inside of the spacer. This study sought to determine whether this diminishes the bronchodilator effect of albuterol.
Study Population. Ninety children with asthma, 4 to 8 years old.
Methods. Spacers evaluated: plastic (washed in water or detergent): Aerochamber and Volumatic; metal: Nebuchamber. Electrostatic charge measured. Peak flow measured at baseline and after inhalation of 1 puff and then 3 more puffs of albuterol.
Results. The plastic spacers carry an electrostatic charge that is still present after washing in plain water but largely eliminated after washing in detergent. The metal spacer carries no electrostatic charge. Although inhaling 4 puffs of albuterol resulted in slightly more bronchodilation than 1 puff with all spacers, there was no difference in the bronchodilation achieved at a given dose whether the spacer carried an electrostatic charge or not.
Conclusions. “This study showed no negative influence of electrostatic charge on plastic spacers with regard to clinical efficacy of a β2-agonist (salbutamol) in children with asthma. The metal Nebuchamber, plastic Aerochamber, and plastic Volumatic were equally effective.” Also, “experiments with one spacer device or drug cannot be extrapolated to others.”
Reviewer’s Comments. Previous studies have shown that washing plastic spacers in detergent and then letting them air dry without rinsing increases the delivery of respirable-sized particles. So even though it may not matter with albuterol, it still seems like a good idea to detergent wash spacers in this fashion when they are new, and at some interval as they become visibly coated with powder.
- Dompeling E, Oudesluys-Murphy AM, Janssens HM, et al. Arch Dis Child.2001;84 :178– 182
- Copyright © 2002 by the American Academy of Pediatrics