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Usefulness of Nonvalved Spacers for Administration of Inhaled Steroids in Young Children with Recurrent Wheezing and Risk Factors for Asthma

Title: Usefulness of Nonvalved Spacers for Administration of Inhaled Steroids in Young Children with Recurrent Wheezing and Risk Factors for Asthma
Authors: Kofman, Carlos; Teper, Alejandro
Source: Canadian Respiratory Journal ; volume 2018, page 1-5 ; ISSN 1198-2241 1916-7245
Publisher Information: Wiley
Publication Year: 2018
Collection: Wiley Online Library (Open Access Articles via Crossref)
Description: Background . In vitro and scintigraphic studies have suggested that effectiveness of metered-dose inhalers (MDI) with nonvalved spacers (NVS) is similar to that of MDI with valved holding chambers (VHC). Nevertheless, there are no clinical studies that compare these techniques in long-term treatment with inhaled steroids in young children with recurrent wheezing and risk factors for asthma. Objective . To compare the efficacy of a long-term treatment with Fluticasone Propionate administered by an MDI through both type of spacers, with and without valves, in young children with recurrent wheezing and risk factors for asthma. Patients and Methods . Outpatient children (6 to 20 months old) with recurrent wheezing and risk factors for asthma were randomized to receive a 6-month treatment with metered-dose inhaler (MDI) of Fluticasone Propionate 125 mcg BID through an NVS or through a VHC. Parents recorded daily their child’s respiratory symptoms and rescue medication use. Results . 46 patients of 13.4 ± 5 months old were studied. During the study period, the NVS group ( n = 25 ) experienced 3.9 ± 2.4 obstructive exacerbations, and the VHC group ( n = 21 ) had 2.6 ± 1.6 ( p = 0.031 ). The NVS group had 17.4 ± 14% of days with respiratory symptoms, and the VHC group had 9.7 ± 7% ( p = 0.019 ). The NVS group spent 29.8 ± 22 days on albuterol while the VHC group spent 17.9 ± 11 days ( p = 0.022 ). Conclusion . Long-term treatment with inhaled steroids administered by MDI and NVS is less effective than such treatment by MDI and VHC in infants with recurrent wheezing and risk factors for asthma.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1155/2018/3095647
Availability: https://doi.org/10.1155/2018/3095647; http://downloads.hindawi.com/journals/crj/2018/3095647.pdf; http://downloads.hindawi.com/journals/crj/2018/3095647.xml
Rights: http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.243E2E3A
Database: BASE