Valved holding chamber drug delivery is dependent on breathing pattern and device design

What is it about?

In young children, inhaled asthma medication is administered through the use of valved holding chambers (VHCs) to improve drug delivery to the lungs. Small children with airway obstruction have shallow and rapid breathing. These extreme respiratory conditions affect drug delivery unpredictably through valved holding chamber devices. We compared - in an experimental setting - the effectiveness of two VHCs, one small (140 ml, Optichamber Diamond) and one large (350 ml, Babyhaler), to deliver salbutamol asthma medication in different breathing conditions. The amount of drug (salbutamol) delivered through the VHC devices increased with increasing depth of inhalation and respiratory rate in both VHCs. However, we found marked differences in salbutamol delivery between the Babyhaler and Optichamber Diamond VHCs. There was up to a 12-fold difference in drug delivery efficacy between the two devices. Instead of considering all VHCs equal in clinical paediatric practice, each device should be tested in vitro with respiratory patterns relevant to small children with respiratory difficulties.

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