Evid Based Nurs 10:74 doi:10.1136/ebn.10.3.74
  • Treatment

Delivery of a β2 agonist by metered dose inhaler with a bottle spacer was equivalent to delivery by conventional spacer in young children with acute lower airway obstruction

 Q In young children with acute lower airway obstruction, is response to bronchodilator treatment given using a metered dose inhaler (MDI) with a bottle spacer equivalent to that given using a conventional spacer?



randomised controlled equivalence trial.




blinded ({healthcare providers, data collectors},* and clinical outcome assessors).

GraphicFollow up period:

after completion of 3 bronchodilator treatments.


a children’s hospital in Cape Town, South Africa.


400 children aged 2 months to 5 years (median age 12 mo, 39% boys) who presented with clinical signs of acute lower airway obstruction (expiratory wheeze on auscultation or hyperinflation of the chest) and had cough or difficulty breathing within the previous 5 days. Exclusion criteria were bronchodilator use in the previous 4 hours, underlying cardiac or chronic pulmonary disease (other than asthma), stridor, or daily oral corticosteroid treatment for >2 days before presentation.


salbutamol, 500 μg, 5 puffs given at 1 puff every 10 seconds from an MDI using a modified 500 ml plastic …

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