MDI with DIY Spacer versus Nebulizer for Bronchodilator Therapy in Children Admitted with Asthmatic Attack
Lalit Leelathipkul MD*, Pattara Tanticharoenwiwat MD*, Jutinan Ithiawatchakul MD*, Danu Prommin PhD**, Pasu Sirisalee PhD**, Parinya Junhunee BEng**, Orapan Poachanukoon MD*
Affiliation : * Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani, Thailand ** National Metal and Materials Technology Center, National Science and Technology Development Agency, Pathumthani, Thailand
Background : Inhaled bronchodilator treatment given via the pressurized metered-dose inhaler (pMDI) with spacer has been
recommended for an acute asthma treatment. Unfortunately, most of commercially available spacers are at high cost while a
do-it-yourself (DIY) spacer has lower cost as it is made from plastic bottle and siphon pump which are inexpensive and easily-
found materials.
Objective : This study aims to compare treatment response in nebulizer and DIY spacer used for asthmatic children.
Material and Method: A prospective, randomized control study was conducted in children aged 1-15 years old hospitalized
for mild to moderate asthmatic attack at Thammasat University Hospital between June 2014 and March 2015. The patients
were divided into 2 groups, receiving β
2-agonist via nebulization and via pMDI with DIY spacer. Their vital signs and oxygen
saturation were monitored and asthma scores were also recorded at admission, 24 hours, 48 hours, and before discharge.
The satisfaction of equipment use was evaluated employing questionnaires.
Results : 40 childrens were enrolled with male at 72.5% and mean age at 3.1+1.6 years old. There was no significant
difference in efficacy of β
2-agonist among 2 groups when comparing in consideration of vital signs, oximetry, asthma scores
and hospital stay. However, there were significantly different on side effect in which the DIY spacer had less tachycardia and
agitation. Satisfaction of parents and healthcare workers were higher in DIY spacer.
Conclusion : MDI with DIY spacer was able to be used effectively when compared with nebulization to treat mild to moderate
acute exacerbations of asthma in children admitted in hospital.
Keywords : DIY spacer, Valved-holding chamber with mask, Pressurized metered-dose inhaler, Asthmatic attack
