Homemade valved holding chambers for children with airway hyperresponsiveness: A randomized crossover trial

Abstract

Background: During the COVID-19 pandemic, a metered-dose inhaler (MDI) with a valved holding chamber (VHC) is a preferred route of bronchodilator delivery. We have developed a new homemade VHC, made of a paper coffee cup, and a drinking water bottle. This study was conducted to compare the bronchodilator response in children with airway hyperresponsiveness after the use of our homemade VHC and that of a standard commercial one. Methods: In a randomized, two-period, two-sequence crossover trial, we recruited 20 children, aged 6-15 years, who had a greater than 12% increase in FEV1 after inhaled salbutamol. They were randomized into Group A and B. Group A used our VHC on the first day and Aerochamber® on the second day. Group B used the same VHCs but in alternate sequence. Spirometries were performed before and after 400 µg of salbutamol, MDI was administered via those VHCs. Results: Baseline demographic data and spirometric values did not have statistically significant differences between group A and B and between the first and second day (p >.05). After giving salbutamol MDI, both VHCs produced significant increases in FVC, FEV1, and FEF25-75% (p <.005). The improvement in FEV1 did not significantly differ between our homemade VHC and Aerochamber® (p >.05). Conclusion: Our homemade VHC is effective for an MDI bronchodilator delivery. Since it is very cheap and easy to make, it may be used as a disposable device to minimize airborne transmission especially when commercial VHC is not available.