Content
- What is an inhalation spacer, how it works
- Efficiency of inhalation without and with a spacer
- Device advantages
- Improving the effectiveness of inhalation therapy
- Reducing the risk of side effects
- Types of devices, selection criteria for children
- Dimensions (edit)
- Number of valves
- Indications for use
- Contraindications
- What medicines can be used for children's inhalation?
- Dosage regimen of drugs
- The technique of inhalation administration of drugs
- Review of the best spacers
- Free-breath maxi
- Free-breath Baby Flow with baby mask
- Philips Respironics OptiChamber Diamond 1109059
- Free-breath Midi Clear with mask for children
- Philips Respironics OptiChamber Diamond HH1330 / 00 (1109060)
- PARI VORTEX with mouthpiece
- PARI VORTEX with frog mask
- Device prices
- Inhalation spacer video
For children with chronic respiratory diseases special devices called spacers are intended. Medical devices for inhalation provide rapid delivery of an aerosol preparation into the cavity of the target organ. Prices for such devices determine the volume of the internal tank, design, brand.
What is an inhalation spacer, how it works
The product is a sealed chamber that acts as an intermediate reservoir for aerosol medication. This is an auxiliary device that increases the effectiveness of symptomatic treatment of pathologies of the respiratory system.
A spacer for inhalation, the price of which is available to a wide range of buyers, connects the aerosol dispenser with the child's airway. The intermediate chamber solves the problem of coordinating inspiration with the nebulization rate of the drug substance. This is especially true for preschool children.
Structurally, the product is an oblong nozzle for a medical nebulizer that extends nebulizer mouthpiece and increasing the accuracy of transporting medication to the pulmonary or bronchial cavity. The principle of operation of the spacer consists in the formation of a finely dispersed drug cloud with a particle size of a drop of 2-5 microns. This size of the substance ensures its penetration into the distal parts of the bronchial organ without delay on the mucous membrane.
Efficiency of inhalation without and with a spacer
In pulmonary practice, metered-dose inhalation drugs are common. They are distinguished by their general availability and therapeutic effectiveness. The use of such drugs for children is associated with a number of difficulties. The aerosol jet has an initial speed of at least 100 km / h.
This indicator significantly exceeds the child's breathing rate. The outgoing flow is made up of droplet particles of different sizes. Synchronization of the absorbed cloud with physiological respiration is required, which a nebulizer without a spacer does not provide. In some children, there is a reflex interruption of inspiration.
The auxiliary nozzle allows you to inject any drugs, including hormonal ones, in large doses. This method of administration provides effective symptomatic treatment with a minimum of local side effects and mucosal irritation.
When inhaled without using a spacer, the drug enters the cavity of the target organ partially. A significant proportion of the drug is absorbed by the epithelial membrane of the dental zone, nasopharynx, and is sprayed into the air.
Device advantages
The use of a spacer ensures fast, accurate and complete delivery of the inhaled drug to the pathological lesion area. The intermediate nozzle guarantees an even distribution of the aerosol cloud in the respiratory organs.
Improving the effectiveness of inhalation therapy
The use of a spacer reduces the likelihood of an effect called cold freon and caused by premature interruption of inspiration. The device simplifies the technique of taking inhaled drugs.
Improving the effectiveness of therapy using an intermediate chamber consists in:
- slowing down the rate of nebulization of the drug substance;
- screening out large particles;
- fast and accurate delivery of small drops to distant tissues of the respiratory organs;
- no need to coordinate the child's respiratory activity with the speed of the nebulizer;
- the presence of a special complete mask that allows the use of inhalation drugs for seriously ill children who are unable to control breathing.
The compactness of pocket devices makes it possible to have a medical device constantly at hand for quick relief of sudden bronchial spasm.
Reducing the risk of side effects
Taking inhaled drugs is associated with the occurrence of negative reactions of the body to the intake of potent physiologically active substances. Hormonal aerosols designed to relieve bronchial spasm have a particularly large number of side effects.
Spacer for inhalation (the price of a particular model depends on the volume of the intermediate chamber, material of manufacture, other factors affecting the cost) allows you to reduce the risk of a negative response of the body to the applied a drug.
The absorption of hormonal aerosol formulations into the mucous membrane causes in children:
- a strong attack of reflex cough;
- dysphonia - a change in the timbre of the voice;
- oral candidiasis;
- systemic adverse effects when using antagonists b2-adrenergic receptors.
The use of an intermediate nozzle reduces oropharyngeal drug deposition by up to 17%, which reduces the risk of developing local side effects and excludes absorption into the epithelium of the gastrointestinal path.
Types of devices, selection criteria for children
Devices are classified by type depending on the volume of the chamber, additional accessories, and the number of valves. The criteria for choosing a spacer are determined by the age of the child, the drug used, and the functional state of the respiratory canals.
Dimensions (edit)
For children under 2 years old, a spacer with a sealed chamber with a volume of 150-200 ml is considered the best option. For a preschooler, a device with an intermediate tank of 350 ml is suitable.
For an older child, it makes sense to purchase a universal device that can be used until adulthood. There is no generally accepted standardization of sizes. The dimensions of the products of each manufacturer are different.
There are Chinese, domestic, German spacers on sale. For a preschool child, a model with dimensions of 173x85x70 mm is suitable. A teenager can buy a spacer 35-40 cm long. Such models are intended for home administration of large doses of inhaled drugs.
Number of valves
The main purpose of the nebulizer extension nozzle is to synchronize breathing activity with the nebulized flow. The improved 2-valve models do the job better.
![Inhalation spacers for children. How to use](/f/fbe714b2e31a484fd566d817c0e91a65.jpg)
It is recommended to buy such a device for a child. One valve coordinates inhalation, the other coordinates exhalation. The functional elements of the design reduce the loss of inhalation medication, simplify the procedure for taking it in the form of an aerosol cloud.
Inhalation of the solution opens the corresponding valve, simultaneously with exhalation, the other flap closes. The inhalation process is automatic.
Dosing of the inhaled air stream with the medicinal aerosol contained in it:
- increases the accuracy of the substance entering the pathological focus;
- reduces the effect of dispersion;
- prevents the settling of fine particles on the posterior surface of the larynx;
- reduces the frequency of adverse reactions;
- increases the effectiveness of inhalation therapy.
The medicinal solution remaining in the sealed chamber is suitable for reuse. Spacers with 2 valves are designed to relieve frequent bronchospasms in a child.
They are used for the symptomatic treatment of respiratory pathologies requiring higher doses of the drug. Such a device is especially recommended for a baby with an innate tendency to allergic reactions.
Indications for use
The spacer is used in the treatment of bronchial asthma in children of any age. The inhalation nozzle is used to eliminate the respiratory symptoms of systemic diseases of allergic genesis. For this therapy, models with 2 valves are suitable, the price of which is higher than that of products with a single leaf.
The device is indicated for use in any pulmonary pathology in children or diseases of the upper respiratory system. The auxiliary tip reduces the risk of complications due to the accumulation of the drug composition in the tissues of the dental cavity or nasopharyngeal surface.
Common diagnoses for which a spacer is indicated for use are presented in the table:
Disease | Pathophysiological characteristics |
Chronic lung obstruction | A progressive process with an inflammatory component, impaired patency of the bronchial tree, morphological changes in the lung tissue and vessels feeding the organ. |
Acute laryngeal stenosis | Short-term spasmodic narrowing of the airway with inspiratory dyspnea, dysphonia, cyanosis of the skin of the face and hands. |
Cystic fibrosis | Severe congenital pathology, occurring with damage to the respiratory tissues, digestive organs, and other functional disorders. |
Bronchiectasis | Disease with irreversible changes in the bronchial tree - pathological expansion of the canal, deformation of the walls and functional inferiority of the respiratory organs. |
The spacer is used to deliver inhaled drugs for pneumonia or acute viral infection of the child's respiratory system. The attachment is necessary for the treatment of children with allergic bronchitis or bronchiolitis - an inflammatory lesion of the alveolar sections of the organ.
Contraindications
Inhalation procedures using a spacer are not prescribed for children with pneumothorax - the accumulation of gases in the pleural cavity.
Treatment with aerosol preparations is prohibited when:
- bullous emphysema - a pathological process accompanied by respiratory dysfunctions and destructive morphological transformations in the alveolar walls;
- insufficiency of pulmonary or cardiac activity of the III degree;
- active internal bleeding;
- acute vascular hypertension;
- severe atherosclerosis of the coronary or cerebral arteries;
- vestibular disorders;
- tubotitis - inflammation of the epithelium of the Eustachian tubes and tympanic cavity;
Contraindications to the use of an extension attachment for a nebulizer are atrophic rhinitis, a tendency to epileptic seizures, and individual intolerance to an aerosol medication.
What medicines can be used for children's inhalation?
The medicinal products contained in the inhalation balloon and delivered using a spacer belong to different pharmacological groups.
Apply:
- bronchodilators - Salbutamol, Berodual;
- corticosteroid substances - Beclomethasone, Budesonide;
- mucolytic medicines - Ambroxol, Lazolvan;
- anesthetics - lidocaine;
- antibiotics - Gentamicin, Torbamycin;
- immunomodulators - Interferon, Derinat.
Antihistamines, vasodilator drugs, phytopreparations are suitable for feeding with a spacer. Do not use powder forms, oily solutions.
Dosage regimen of drugs
The volumes of the drug and the frequency of administration are individually determined by the pediatrician or pulmonologist based on the clinical picture of the disease, the age of the child, and individual tolerance.
When choosing a dosage regimen, the presence of concomitant pathological processes is taken into account. Typically, each inhalation procedure takes 1 full breath of the aerosol cloud.
To eliminate bronchial spasm, make 2-3 calm breathing movements. The frequency of application varies within 3-6 inhalation sessions. The time intervals between them are 2-12 hours. depending on clinical need and duration of drug action.
When taking 2 doses of the drug in a row between breaths, take a break for 30-60 seconds. For children with a weakened body, delayed inhalation of a single volume of the drug is allowed for 20-30 seconds.
The standard therapeutic protocol provides for the delivery of inhaled medication in a course manner with a doctor monitoring the child's condition, monitoring the effectiveness of the treatment procedure, the tolerance of the pharmacologically active substances.
The technique of inhalation administration of drugs
The result of therapy largely depends on the correct use of the device. Previously, the pediatrician or pulmonologist instructs the child with parents on the technique of administering aerosol preparations and precautions.
The spacer for inhalation, the price of which is low in the context of increasing the effectiveness of treatment, greatly facilitates the procedure for taking nebulized medicinal formulations.
The algorithm of the procedure for children is as follows:
- Remove the protective cap from the inhalation balloon and spacer.
- Attach a mask when using it.
- Expand the balloon with the drug upside down, with the mouthpiece down.
- Grasp the cut of the intermediate device tightly with your lips without closing your teeth.
- Inhale deeply in sync with pressing the valve of the inhalation balloon.
- Hold your breath for 5-10 seconds.
- Exhale completely.
After the completion of the treatment session, the structure is disassembled, the spacer is washed and dried. It is forbidden to use hot water, household chemicals, alkaline compounds for sanitizing the device.
Review of the best spacers
There are many child-friendly devices available. Spacer models differ in the material of manufacture, the volume of the sealed tank, and additional options. Below are the most popular baby gadgets.
Free-breath maxi
A universal model made in China. It is intended for administration of metered-dose inhalation drugs by children of any age. The device is compatible with all inhalers.
The complete adapter adapter provides precise centering and positioning of the spray. It directs the aerosol cloud into the chamber, reducing drug consumption. The device is equipped with an inhalation-exhalation flap. The volume of the tank is 350 ml.
Free-breath Baby Flow with baby mask
The spacer is intended for the treatment of children under 5 years of age. The set includes 3 masks of different sizes. The volume of the sealed chamber is 175 ml. The device is equipped with a special fixing cuff for compatibility with different types of inhalation balloons.
The spacer is made of medical grade antiseptic polymer. The material has improved antistatic properties. The mouthpiece with a mouthpiece is closed with a protective cap.
Philips Respironics OptiChamber Diamond 1109059
The American-made spacer reduces the likelihood of irritation of the laryngeal mucosa. The model allows you to save medicines, effectively delivers the sprayed composition to the bronchial cavity with a uniform distribution.
The device coordinates the aerosol stream with the child's respiratory activity, ensuring that the smallest particles enter the therapeutic zone. The volume of the sealed chamber is 140 ml. The spacer is 11 cm long and 50 mm in diameter.
Free-breath Midi Clear with mask for children
The model is equipped with a removable adapter-adapter that ensures compatibility of the spacer with any inhalation balloons. The part is easily detached for cleaning and sanitation.
The inspiratory flap prevents airflow from entering the sealed drug reservoir. The protective cap protects the mouthpiece from contamination. The device has a sound notification of an error during use.
Philips Respironics OptiChamber Diamond HH1330 / 00 (1109060)
The spacer for inhalation (the price of the device ranges from 1100-2130 rubles) is suitable for receiving aerosol preparations of any pharmaceutical category. The design contains built-in valve flaps with low resistance to inhalation or exhalation.
The device is made of sterile transparent medical polymer. An integrated whistle helps control the rate of breathing. The device provides a uniform distribution of finely dispersed medicinal suspension over the surface of the bronchial cavity.
PARI VORTEX with mouthpiece
The German-made children's spacer is implemented using a unique cyclone technology patented by the manufacturer. Silicone swirls inside the sealed reservoir break the particles of the drug formulation into a microscopic suspension.
This facilitates the intake of the drug by young children and with difficulty breathing. The spacer is equipped with an original adapter-adapter for cylinders of different designs.
The material of manufacture has improved antistatic and antiseptic characteristics. The sterility of the mouthpiece is ensured by a tight protective cap. The model with a mouthpiece is distinguished by its miniature size, ease of use, and high therapeutic efficiency.
Cyclonic technology ensures that the aerosol cloud completely overcomes the oropharynx without side effects or discomfort. The drug successfully reaches the pathological zone without loss.
PARI VORTEX with frog mask
The German spacer is used to optimize the therapeutic delivery of inhaled medications. The device slows down the spray rate to synchronize with the baby's breathing.
The accumulation of aerosol suspension in a sealed chamber allows the baby to take a few breaths in a calm mode. This is of significant therapeutic value when taking bolus doses of inhaled glucocorticosteroids.
The transparent surface of the mouthpiece with anatomically adjusted mouthpiece allows you to visually control the treatment process. Silicone blades attached to the adapter generate a vortex flow.
They ensure complete delivery of the drug to the target therapeutic area. The set includes 2 masks - "ladybug" for newborns and "frog" for children over 2 years old. A unique feature of the model is the ability to use it with one hand.
Device prices
The cost of intermediate devices for taking inhaled drugs is available to a wide range of buyers. The price of the Free-breath Maxi model is about 1,500 rubles. For Free-breath Baby Flow in a medical equipment store or in a pharmacy, you will have to pay 1330 rubles.
The innovative German spacer for inhalation PARI VORTEX with a mouthpiece or a “frog” mask costs about 1,780 rubles. Free-breath Midi Clear price is about 1600 rubles. The cost of other popular models is similar.
Inhalation spacer video
Inhalation technique with a spacer for bronchial asthma: