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Advantages of a Spacer Device Increases drug delivery to the lungs. Reduces side effects of drugs. Allows young children to get the benefits of   inhaled therapy,   by bypassing the need to coordinate breathing and activation of a pressured inhaler. Babies less than a year old can also use a spacer, with the addition of a face mask.

Spacer Devices for Asthma

Spacers are devices made of polycarbonate or metal, which have made a big difference to the treatment of children with asthma. The advantages of   inhaled therapy   are well known, but children below the age of five years usually cannot use a  metered dose inhaler. The other type of devices, dry powder inhalers, also cannot be used by very young children.

How Spacers Work

Spacers are simply cylinders with a hole at one end and a mouthpiece at the other. The hole is for a metered dose inhaler to fit, and the child holds the mouthpiece between the lips. When the inhaler is activated, the drug is released into the air within the cylinder.

The child can then inhale the drug in with normal breathing through the spacer. This freedom from the need to coordinate breathing and activation of the inhaler allows children as young as 3 years to use an inhaler. A face mask fitted to the mouthpiece allows use by even younger children.

Advantages of a Spacer

The most important, of course, is that the drug is held suspended in the air inside the chamber, allowing the child to inhale it over the next minute or so. There is no need to try to time the activation of the inhaler with breathing in. This timing is very difficult for children, especially when having an acute attack.

When using an inhaler directly, only about a tenth of the drug reaches the lungs. When using a spacer, about 20% of the drug reaches the lungs. This increased drug delivery improves treatment efficacy.

Most of the drug released by direct use of an inhaler is deposited inside the mouth of the child, from where it is swallowed. This swallowed drug increases side effects of the drug. With a spacer, about 60% of the drug from the inhaler is deposited on the walls of the chamber, and only about 20% in deposited in the mouth. Side effects are thus reduced. This is very important when using inhaled steroids.

Care of a spacer

Spacers are made of plastics or metal. These can be dismantled and washed easily, which keeps them clean and free of germs.

Plastic spacers collect static electricity charge on their walls. This attracts the drug particles to them, reducing availability of the drug. Washing regularly removes the charge. polycarbonate spacers made of non electrostatic material are also available now. Metal spacers do not collect static electricity, but are not very common.

Cost considerations

Spacers come in various sizes, from 165 to 750 millilitres. Their cost varies from Rs. 150 to Rs. 370. Spacers are available free with certain inhalers. A mask for babies costs around Rs. 100.

Last revision: July 15, 2007

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