Comparison inhalation with pMDI and pMDI/spacer on drug delivery in the lung using FRI technology

Published in: Am J Respir Crit Care Med 2020;201:A5689

Authors: J. Suggett1, V. Kushnarev(1) , C. Van Holsbeke (2) , S. Van Steen(2) , B. Mignot(2)

1) Trudell Medical International, London, ON, Canada. 2)  Fluidda, Antwerp, Belgium.

Rationale of research

  • Evaluations of inhaler use have demonstrated that mishandling of pMDIs ( pressurized meter dose inhalers) is commonplace.
  • One of the most common errors is the failure to coordinate inhalation with actuation of the inhaler.
  • One of the reasons why Valved Holding Chambers (VHCs)  are often prescribed is to reduce the severity of this error

This Functional Respiratory Imaging (FRI) based study assessed the likely severity of a short inhalation delay (from actuation) with a pMDI  alone and how it contrasted to the use with a VHC.



  • The FRI deposition profiles highlight the significant negative impact on lung deposition of even a relatively short 0.5 second delay between actuation and inhalation when an MDI is used alone.
  • Intrathoracic lung delivery decreased from 25.4mcg to 0.3mcg.
  •  Extrathoracic delivery (related to oropharyngeal deposition) was consequently even higher.
  •  The MDI / AeroChamber Plus* Flow-Vu* VHC system with a 2 -second delay delivered 28.7 mcg to the intrathoracic region with a  greater central lung delivery compared to MDI alone (perfect coordination). This may be suggestive of greater delivery to beta-adrenoreceptors.
  • These results further the message that the use of an appropriate VHC should be considered as general practice for all people using MDIs other than those with a highly proficient inhaler technique.

Categorised in: / June 4, 2020 3:30 pm / Published by

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