RT Journal Article
SR Electronic
T1 Safety of inhaled corticosteroids delivered by plastic and metal spacers
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 527
OP 528
DO 10.1136/adc.88.6.527
VO 88
IS 6
A1 I Amirav
A1 Y Mansour
A1 T Tiosano
A1 S Chamny
A1 S Chirurg
A1 S Oren
A1 Z Grossman
A1 L Kahana
A1 E Kahan
A1 M T Newhouse
YR 2003
UL http://adc.bmj.com/content/88/6/527.abstract
AB Background: Because of its non-electrostatic properties the metal Nebuchamber (NC) valved holding chamber (VHC) delivers a greater mass of aerosol to the mouth than the polypropylene Aerochamber (AC) VHC. Delivery of more aerosol to the lungs may also increase systemic absorption of inhaled corticosteroids (ICS) and hypothalamo-pituitary-adrenal (HPA) suppression. Methods: Thirty children (mean 4.3 (SD 0.3) years) received 200 μg budesonide twice daily by NC or AC, both with the mask provided, in a randomised, two month crossover trial. Twenty four hour urinary free cortisol (UFC) was determined as a measure of HPA suppression. Results: UFC decreased from 42.3 (7.8) nmol UFC/nmol creatinine control to 26.2 (2.4) (p = 0.06 v control) after AC, and to 24.5 (2.5) (p = 0.04 v control) after NC (p = 0.4 AC v NC). Conclusions: Despite a greater total dose delivered to the mouth, NC is not associated with greater HPA suppression when using 400 μg/day budesonide under real life conditions in young children.