Aerosol Treatment of Bronchoconstriction in Children, with or without a Tube Spacer

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Abstract
To assess whether an extension tube between the aerosol source and the patient improves drug-inhalation therapy in children with acute bronchoconstriction, we treated 20 children under double-blind conditions with placebo or terbutaline delivered by a conventional aerosol or an aerosol with a tube spacer. Both terbutaline treatments resulted in a significant increase in forced expiratory volume in one second, as compared with placebo (P<0.001), but treatment with the tube-spacer aerosol produced significantly more improvement than did treatment with the conventional aerosol (P<0.01). The number of errors in inhalation technique was reduced when the spacer aerosol was used, and this reduction may account for the greater improvement in the children treated with the spacer. (N Engl J Med 1983; 308:1328–30.)