PT  - JOURNAL ARTICLE
AU  - Jason Suggett
AU  - Mark Nagel
AU  - Cathy Doyle
AU  - Heather Schneider
AU  - Jolyon Mitchell
TI  - Valved holding chambers (VHCs) can have different medication delivery performance as a function of delay interval following actuation of the pressurized metered dose inhaler (pMDI)
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P3812
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P3812.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P3812.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - RATIONALE: VHCs are prescribed for patients who cannot coordinate inhalation with actuation of a pMDI. Performance of these add-on devices as a function of delayed inhalation is therefore critical. The present study explored the in vitro performance of three different anti-static VHCs, simulating 5 s and 10 s delays.METHODS: 5 actuations of Seretide® 250µg fluticasone propionate (FP)/25µg salmeterol xinafoate (SX) (GSK) were delivered to AeroChamber Plus* Anti-Static VHC with Flow-Vu* IFI ((AC-Plus) Trudell Medical International), OptiChamber® Diamond® VHC ((OD) Philips Respironics) and Vortex™ ((Vortex) PARI Respiratory Equipment) non electrostatic VHC (n=5 devices/group). Each VHC was used out-of-package and connected to an Andersen Mk II cascade impactor operated at 28.3 L/min. A proprietary apparatus enabled the required delay interval to be simulated. Recovered FP and SX were assayed using HPLC-UV spectrophotometry.RESULTS: Measures (mean ± SD) of therapeutically beneficial fine particle mass < 4.7 µm aerodynamic diameter (FPM<4.7 µm) are summarized in the table.View this table:CONCLUSIONS: FPM was significantly greater using the AC-Plus VHC compared to the OD and Vortex VHCs for both components at both time delays (1-way ANOVA, p ≤ 0.002). The clinical impact of potential under-dosing with poorly coordinated patients should be considered when selecting a VHC.