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Evaluation of the influence of patient age and spacer device volume on aerosol lung deposition

OBJECTIVE: To evaluate the efficacy of three frequently used spacer devices to deliver aerosol to the lung, and to compare radioaerosol deposition with each device in different age groups. METHODS: Nine healthy, non-smoking volunteers were recruited: three adults and six children, including three toddlers and three school age children. Qualitative and semi-quantitative analysis of radioaerosol deposition in the lung were carried out. Yet, two small-volume devices (Aerochamber® and Inal-Air®) and one large-volume device (Flumax®) were compared. Each patient inhaled 99m technetium-phytate. The device was filled during 30 seconds with radioaerosol. Oxygen was used as the driving gas. During 10 seconds, the patients inhaled the radioaerosol. The radiation emitted at the front and back of the chest was measured. The radiation inside the device was also measured. RESULTS: The quantitative evaluation of lung deposition revealed that the younger the patient, the less aerosol was deposited in the lung with the large-volume spacer device (Flumax®). The difference between small-volume devices (Aerochamber® and Inal-Air®) was not significant. CONCLUSION: Small-volume spacers are the most appropriate for children. Large-volume devices should only be used by adolescents and adults.

Inhalation therapy; spacers; 99m technetium-fitate


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