Trial reportThorax1996
Effect of multiple actuations, delayed inhalation and antistatic treatment on the lung bioavailability of salbutamol via a spacer device.
Trial report in Thorax, 1996. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 95 citations in OpenAlex.
- Inhalation devices.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2005Guideline
- Canadian Asthma Consensus Report, 1999. Canadian Asthma Consensus Group.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 1999Guideline
- Salbutamol effects on systemic potassium dynamics during and following intense continuous and intermittent exercise.European journal of applied physiology · 2016Trial
- Comparison of the systemic bioavailability of mometasone furoate after oral inhalation from a mometasone furoate/formoterol fumarate metered-dose inhaler versus a mometasone furoate dry-powder inhaler in patients with chronic obstructive pulmonary disease.International journal of chronic obstructive pulmonary disease · 2013Trial
- Comparative lung bioavailability of fluticasone/salmeterol via a breath-actuated spacer and conventional plastic spacers.European journal of clinical pharmacology · 2011Trial
- In vivo comparison of the relative systemic bioavailability of fluticasone propionate from three anti-static spacers and a metered dose inhaler.British journal of clinical pharmacology · 2009Trial
- Respirable dose delivery of fluticasone propionate from a small valved holding chamber, a compact breath actuated integrated vortex device and a metered dose inhaler.British journal of clinical pharmacology · 2008Trial
- The presence of emphysema does not affect the systemic bioactivity of inhaled fluticasone in severe chronic obstructive pulmonary disease.British journal of clinical pharmacology · 2004Trial
- Effect of plastic spacer handling on salbutamol lung deposition in asthmatic children.British journal of clinical pharmacology · 2002Trial
- Pharmacokinetics and systemic beta2-adrenoceptor-mediated responses to inhaled salbutamol.British journal of clinical pharmacology · 2001Trial
- Effect of electrostatic charge in plastic spacers on the lung delivery of HFA-salbutamol in children.British journal of clinical pharmacology · 1999Trial
- Early lung absorption profile of non-CFC salbutamol via small and large volume plastic spacer devices.British journal of clinical pharmacology · 1998Trial
- Lung delivery of non-CFC salbutamol via small volume metal spacer and large volume plastic spacer devices compared with an open vent jet nebulizer.British journal of clinical pharmacology · 1998Trial
- Flow rate dependence of salbutamol dose with various valved holding chambers in vitro.BMC pulmonary medicine · 2026Article
- Optimal administration of bronchodilators with valved holding chambers in preschool children: a review of literature.European journal of pediatrics · 2021Review
- Wheeze in childhood: is the spacer good enough?Singapore medical journal · 2014Article
- The challenge of delivering therapeutic aerosols to asthma patients.ISRN allergy · 2013Article
- Long-term management of asthma.Indian journal of pediatrics · 2003Review
- Use of inhaler devices in pediatric asthma.Paediatric drugs · 2003Review
- Methods to identify drug deposition in the lungs following inhalation.British journal of clinical pharmacology · 2001Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of this study was to extend previous in vitro observations regarding the effects of multiple actuations of aerosols into spacer devices, delayed inhalation, and antistatic treatment of spacer devices on the amount of drug delivered for inhalation. An in vivo study of lung bioavailability of salbutamol from a large volume (Volumatic) spacer was conducted.
methodsTen healthy volunteers of mean age 20.5 years with a mean forced expiratory volume in one second of 112.1% predicted were studied in a randomised single blind (investigator blind) crossover study. 1200 micrograms of salbutamol was given with mouth rinsing (100 micrograms/puff) on four study days: single puffs via spacer, multiple puffs via spacer (3 x 4 puffs), single puffs with 20 second delay before inhalation via spacer, and single puffs via an antistatic treated spacer. All spacers, including those treated with antistatic, were prewashed prior to each study day. Measurements of lung bioavailability were made at five, 10, and 20 minutes after inhalation to determine peak (Cmax) and average (Cav) plasma salbutamol levels. Systemic beta 2 responses including finger tremor, heart rate, and plasma potassium levels were also evaluated.
resultsSingle puffs from the spacer produced higher plasma salbutamol levels and greater systemic beta 2 responses than either multiple puffs or single puffs with delayed inhalation for a 1200 micrograms dose. For Cmax this amounted to a 1.93-fold (95% CI 1.68 to 2.19) greater lung bioavailability for single puffs than for multiple puffs and a 1.80-fold (95% CI 1.59 to 2.00) greater lung bioavailability for single puffs than for single puffs with a 20 second delay. Comparison of the normal and antistatic treated spacers (both prewashed) revealed differences for Cmax with levels 1.23-fold (95% CI 1.04 to 1.41) greater for the normal spacer.
conclusionsDelayed inhalation from a Volumatic spacer and the use of multiple puffs results in a considerable decrease in the delivery of salbutamol to the lungs with an approximate twofold reduction in lung bioavailability. Washing a Volumatic spacer is as effective as an antistatic lining in reducing the effects of static charge on salbutamol delivery in vivo.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.