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A Randomized Controlled Trial of 2 Inhalation Methods When Using a Pressurized Metered Dose Inhaler With Valved Holding Chamber.
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). All India Institute of Medical Sciences, New Delhi, India.ORCID iD: 0000-0001-6116-3848
All India Institute of Medical Sciences, New Delhi, India.
All India Institute of Medical Sciences, New Delhi, India.
All India Institute of Medical Sciences, New Delhi, India.
2015 (English)In: Respiratory care, ISSN 0020-1324, E-ISSN 1943-3654, Vol. 60, no 12, p. 1743-1748Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Information on the comparative efficacy of single deep breathing versus tidal breathing for inhaled asthma medications is limited, although such information can be of much use for the treatment of patients suffering from asthma. The objective of the present study was to compare the relative difference in improvement in peak expiratory flow (PEF) with single maximal inhalation with breath-holding versus 5 tidal breaths during inhalation of salbutamol from a pressurized metered dose inhaler (pMDI) with valved holding chamber (VHC) in children 5-15 y of age with asthma.

METHODS: The randomized controlled trial was carried out on children with asthma between 5 and 15 y of age using a pMDI with a VHC either by a single deep breath with breath-hold or 5 tidal breaths. The experimental group received 200 μg of salbutamol from the pMDI with VHC with a single maximal inhalation and breath-hold technique, whereas the control group received 200 μg of salbutamol from pMDI with VHC using the 5 tidal breaths technique. The outcome variable, PEF, was reassessed 30 min after salbutamol use.

RESULTS: Eighty-two subjects (mean age 8.79 ± 2.5 y, 65 boys and 17 girls) were analyzed. There was significant improvement in the PEF, from baseline (pre-intervention) to post-intervention within the single maximal inhalation with breath-hold group and tidal breathing group independently (P < .001). The mean difference in improvement in PEF between the single maximal inhalation with a breath-hold and 5 tidal breaths group was 30.0 ± 18.16 and 28.29 ± 13.94 L/min, respectively, and was not statistically significant (P = .88).

CONCLUSIONS: Single maximal inhalation with a breath-hold technique is not superior to tidal breathing for improvement in PEF following salbutamol inhalation. Either method may be used in children between 5 and 15 y of age. (India's Clinical Trials Registry CTRI/2013/04/003559.).

Place, publisher, year, edition, pages
2015. Vol. 60, no 12, p. 1743-1748
Keywords [en]
Inhalation techniques, single maximal breath with a breath-hold, tidal breathing, salbutamol metered dose inhaler, valved holding chamber techniques, metered dose inhaler techniques
National Category
Nursing Pediatrics
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:kau:diva-71582DOI: 10.4187/respcare.03213ISI: 000365758400007PubMedID: 26081179OAI: oai:DiVA.org:kau-71582DiVA, id: diva2:1297553
Available from: 2019-03-20 Created: 2019-03-20 Last updated: 2019-03-21Bibliographically approved

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Stephen, Divya Anna

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