Children, Inhalers and Spacers
· that normal breathing (tidal breathing) is best – in fact the tidal breaths taken were quite large compared to predicted tidal ventilation, probably influenced by the spacer itself.
· Single strong breathing in (maximal inhalation) was no better than normal breathing.
· There was little difference between the spacers tested (Aerochamber, Funhaler, Volumatic, or modified soft drink bottle)...(not even Coca Cola or Pespsi)
· There was no increase in drug delivery beyond that achieved with 2 tidal breaths for a small volume spacer, and 3 for a large volume spacer.
My recommendation still remains at a single puff from the inhaler into the spacer followed by 6-8 normal breathing (what to do, I am kiasu), followed by another puff and 6-8 breaths using a spacer.