Dry-powder inhaler use in primary school-aged children with asthma: a systematic review.

Objective: Asthma is the most common chronic disease among children. Dry-powder inhalers (DPIs) are effective for medication delivery in adults and adolescents, and provide a lower environmental footprint and more portability than a metered dose inhaler (MDI) with a spacer. They require a specific technique, and it is necessary to ascertain whether they can be used in younger age groups.

User-Friendliness Evaluation of Handling pMDI with Various Add-on Devices in Asthmatic Patients.

The objective of this study was to assess the use of pMDI alone and pMDI with different spacers in asthmatic patients and to identify any associations between errors in handling the device for the first time and the sessions needed to reach the correct handling method, considering patient demographics and clinical characteristics. A total of 150 Asthmatic patients were crossed over to handle pMDI alone and with add-on inhalable devices (Aerochamber plus, Tips Haler, Able, Dispozable and Aer-8) randomly, without receiving verbal or demonstrative instruction (baseline assessment). The assessment of the inhaler technique was performed using checklists that had been set beforehand.

Metered-Dose Inhaler Versus Nebulizer Treatment for Acute Asthma Exacerbation: A Process Evaluation.

The prevalence of childhood asthma in the United States is 6.5%. During the COVID-19 pandemic, a Federally Qualified Health Center (FQHC) implemented metered-dose inhalers (MDIs) with spacers instead of nebulized albuterol to reduce aerosolization of pathogens and reduce costs.

Inhaler device selection for people with asthma or chronic obstructive pulmonary disease.

There are many types of inhaler device, each with its own characteristics, benefits and limitations. Inhaler device selection should be individualised. Assessment of the patient's inspiratory flow, dexterity, coordination and preferences can help guide selection of a device that the patient can and will use effectively.

A Novel Common Canister Protocol for Albuterol Sulfate Metered Dose Inhalers: Conservation Strategy and Clinical Outcomes Amid COVID-19 Pandemic.

The COVID-19 pandemic led to unprecedented shortages of albuterol sulfate metered dose inhalers (MDIs) utilized in the supportive management of respiratory symptoms in patients with SARS-CoV-2 infections. The risk of generating infective aerosols in nebulized treatments increased the demand for metered dose delivery, leading to a worldwide shortage of albuterol sulfate MDIs. Previous common canister protocols involve the recycling and cleaning of canisters for multiple patient use, however have not undergone quality control studies on viral cross-contamination.

Performance of newly developed add-on devices on aerosol delivery in noninvasive ventilated subjects.

Several techniques had been developed to generate aerosolized medications during noninvasive ventilation (NIV) using variable inhalation methods. This study hypothesized that large spacers were more efficient significantly than small spacers and adapters during NIV. The main objective of this study was to compare the performance of newly developed spacers with standard T-piece in NIV chronic obstructive pulmonary disease (COPD) subjects.

Comparative performance study of paperboard disposable spacers versus commercial valved holding chambers for aerosol delivery.

Purpose: The aim of this study is to evaluate and compare the performance, for the administration of fluticasone propionate with a pressurized metered-dose inhaler (pMDI), of two low-tech paperboard spacers versus two commercially available valved holding chambers (VHC).

Methods: According to the Canadian standard CAN/CSA-Z264.1-02, total emitted dose (TED) and aerodynamic size distribution were measured for the pMDI in combination with 4 different spacers: a homemade paper cup spacer, the DispozABLE® paperboard spacer, the AeroChamber Plus® plastic VHC, and the Vortex® aluminium VHC.

Bronchodilator administration by pressurized inhaler during invasive mechanical ventilation in adults: A scoping review.

Objective: To identify the administration characteristics and connection methods of bronchodilators by pressurized inhalers to the ventilatory circuit of patients under invasive mechanical ventilation.

Methods: A scope review was conducted following the PRISMA for Scoping Review, using the PubMed, Embase Elsevier, Cochrane Library, and Lilacs databases without language restrictions, up to July 2023. Eligible sources included reviews and consensuses (based on clinical studies), experimental and observational studies involving adult patients admitted to the Intensive Care Unit and undergoing invasive mechanical ventilation, regardless of the underlying condition, who used bronchodilator drugs contained in pressurized inhalers.

Mobile Direct Observed Therapy (MDOT) for Inhaler Therapy in Children With Newly Diagnosed Asthma: A Pilot Study.

Objective: We aimed to assess the acceptability of Mobile Direct Observed Therapy (MDOT) amongst the parents/caregivers of children with asthma.

Methods: This open-label pilot randomized controlled trial enrolled newly diagnosed children aged 5-15 years with asthma, who were followed up telephonically for six weeks. Parents of children in the intervention arm were requested to record a video of the metered dose inhaler with spacer (MDI-S) technique of their child on a mobile phone and share it through WhatsApp with investigator who then provided corrective measures as required by a text/video message.

Small Airways Disease Affects Aerosol Deposition in Children with Severe Asthma: A Functional Respiratory Imaging Study.

Small airways disease (SAD) in severe asthma (SA) is associated with high disease burden. Effective treatment of SAD could improve disease control. Reduced end-expiratory flows (forced expiratory flow [FEF] and FEF) are considered sensitive indicators of SAD.

Pediatric asthma inhaler technique: quality and content analysis of YouTube videos.

Background: Proper technique for using inhalers is crucial in treating pediatric asthma. YouTube offers a wide range of videos on pediatric inhaler technique, but there is a need to analyze the quality, reliability, and content of these resources.

Aims: This study aims to analyze the quality, reliability, and content of YouTube videos on pediatric asthma inhaler techniques.

Bronchodilator administration by pressurized inhaler during invasive mechanical ventilation in adults: A scoping review.

Objective: To identify the administration characteristics and connection methods of bronchodilators by pressurized inhalers to the ventilatory circuit of patients under invasive mechanical ventilation.

Methods: A scope review was conducted following the PRISMA for Scoping Review, using the PubMed, Embase Elsevier, Cochrane Library, and Lilacs databases without language restrictions, up to July 2023. Eligible sources included reviews and consensuses (based on clinical studies), experimental and observational studies involving adult patients admitted to the intensive care unit and undergoing invasive mechanical ventilation, regardless of the underlying condition, who used bronchodilator drugs contained in pressurized inhalers.

Stepping into small shoes: Gaining user perspective on appropriate administration devices for paediatric medication in India.

A cross sectional pan-India study about use of administration devices for paediatric oral and inhalation medicines was conducted with a diverse pool of participants of various age groups. Via 634 respondents from more than 15 states in India, this study has identified the administration devices commonly used by parents/caregivers for children 0 to 18 years and by children over 10 years. It has provided insights on device ease of use, challenges faced and recommendations to facilitate the correct use of administration devices for paediatric oral and inhalation medicines.

Clinical standards for the diagnosis and management of asthma in low- and middle-income countries.

The aim of these clinical standards is to aid the diagnosis and management of asthma in low-resource settings in low- and middle-income countries (LMICs). A panel of 52 experts in the field of asthma in LMICs participated in a two-stage Delphi process to establish and reach a consensus on the clinical standards. Eighteen clinical standards were defined: Standard 1, Every individual with symptoms and signs compatible with asthma should undergo a clinical assessment; Standard 2, In individuals (>6 years) with a clinical assessment supportive of a diagnosis of asthma, a hand-held spirometry measurement should be used to confirm variable expiratory airflow limitation by demonstrating an acute response to a bronchodilator; Standard 3, Pre- and post-bronchodilator spirometry should be performed in individuals (>6 years) to support diagnosis before treatment is commenced if there is diagnostic uncertainty; Standard 4, Individuals with an acute exacerbation of asthma and clinical signs of hypoxaemia or increased work of breathing should be given supplementary oxygen to maintain saturation at 94-98%; Standard 5, Inhaled short-acting beta-2 agonists (SABAs) should be used as an emergency reliever in individuals with asthma via an appropriate spacer device for metered-dose inhalers; Standard 6, Short-course oral corticosteroids should be administered in appropriate doses to individuals having moderate to severe acute asthma exacerbations (minimum 3-5 days); Standard 7, Individuals having a severe asthma exacerbation should receive emergency care, including oxygen therapy, systemic corticosteroids, inhaled bronchodilators (e.