Southwestern United States
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in the Southwest
Spacer Devices for Metered Dose Asthma Inhalers
Spacer devices have a chamber that receives the aerosol before it
is inhaled. They serve two functions:
a) to overcome difficulties in coordinating the timing of the inhaler actuation and
inhalation,
b) to slow down the speed of delivery of the aerosol into the mouth so that less of the
drug impacts in the throat.
Spacers are only partly effective in overcoming poor timing in using
inhalers: if the inhaler is actuated in exhalation instead of the beginning
of inhalation, at least 50% of the dose is lost. Some attributes of various spacers are shown in the Table.
The smaller volume spacers are appropriate for children as well as adults. A valved
chamber with exhalation ports is useful to prevent exhalation into the
chamber and allow inhalation of drug remaining in the chamber after the first
inhalation. However the valve is reported to reduce the inhaled dose.
Loss of drug by deposition on the walls of the spacer can be reduced by
soaking the spacer in water with household detergent and allowing it to dry
without rinsing. A flow rate signal helps to warn the user that the
inhalation is too fast. Universal inhaler adapters conform
to the mouthpiece of any metered dose inhaler, whereas the others have rigid adapters that
fit only one type of mouthpiece.
(For pictures, click links)
| Device | Use in Small Children | Volume | Valved Chamber | Flow rate signal | Inhaler adapter |
| ACE | Yes (with mask) | 170 ml | Yes | Yes | N/A** |
| Aerochamber | Yes (with mask) | 145 ml | Yes | Yes | Universal |
| Easivent | Yes (with mask) | 140 ml | Yes | Yes | Universal |
| Ellipse | No | 175 ml | No | No | Ovoid |
| E-Z Spacer # | Yes (with mask) | 700 ml | No* | No | N/A** |
| Inspirease # | No | 700 ml | No* | Yes | N/A** |
| Medispacer | Yes (with mask) | 175 ml | Yes | Yes | N/A** |
| LiteAire^ | No | 158 ml | Yes | No | Universal |
| Optichamber | Yes (with mask) | 218 ml | Yes | Yes | Universal |
| Nebuhaler | No | 750 ml | Yes | No | Oval |
| Ventahaler | No | 750 ml | Yes | No | Oval |
| RiteFlo† | No | 140 ml | No | No | Universal |
* collapsible chamber
** inhaler canister fits directly into the spacer device
^ collapsible - fits in shirt pocket
# compact
† flow rate limited to the recommended
15-30 L/min, obviating need for a flow rate signal
Further Reading:
Beaucage D, Nesbitt S. Using inhalation devices. in
Comprehensive Management of Chronic Obstructive Pulmonary Disease, Chapter
6. Bourbeau J, Nault D, Borycki E (eds) BC Decker, Hamilton 2002.
Disclaimer: This site is for educational purposes only. Any information that you have found in this web site is not intended to replace medical care or advice given to you by your own physicians. You should consider consulting your local medical library and other web sites for additional information.
Comments and suggestions welcome! Email: schumach@u.arizona.edu
Content Owner: Michael J. Schumacher, MB, FRACP, The
University of Arizona
Updated 8/2008