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Background <p>Correct pressurized metered dose inhaler (pMDI) technique is essential for optimal lung deposition. Although spacer devices are recommended for patients with poor inhaler technique, access and affordability remain barriers. The current research evaluated the in-vitro salbutamol aerosol delivery characteristics through a novel card-based spacer (the MDI Plus<sup>®</sup>), compared to a commercial plastic spacer (AeroChamber Plus<sup>®</sup>).</p> Method <p>An Andersen cascade impactor was used to assess the total emitted dose (TED) and aerodynamic particle size distribution (APSD) of salbutamol emitted from pMDI alone and pMDI attached to two different spacers: the MDI Plus<sup>®</sup> and AeroChamber Plus<sup>®</sup>. Key APSD metrics included fine particle dose (FPD), fine particle fraction (FPF), mass median aerodynamic diameter (MMAD), and geometric standard deviation (GSD). Salbutamol samples were quantified using a validated high-performance liquid chromatography method.</p> Results <p>pMDI alone produced the highest total emitted dose (TED: 368.35 ± 20.26&#xa0;µg), significantly exceeding AeroChamber Plus<sup>®</sup> (207.32 ± 6.39&#xa0;µg) and MDI Plus<sup>®</sup> (193.53 ± 3.18&#xa0;µg) (<i>p</i> &lt; 0.001). MDI Plus<sup>®</sup> had the highest fine particle fraction (FPF: 71.41 ± 3.12%) compared to AeroChamber Plus<sup>®</sup> (58.75 ± 0.89%) and pMDI alone (24.73 ± 2.74%), <i>p</i> = 0.051. MMAD was lowest with MDI Plus<sup>®</sup> (3.88 ± 0.02&#xa0;μm), suggesting smaller, more respirable particles. Both spacers reduced upper airway deposition relative to pMDI alone.</p> Conclusion <p>The current findings support the utility of spacers in optimizing pMDI aerosol delivery. The MDI Plus<sup>®</sup> performed comparably to the AeroChamber Plus<sup>®</sup> in terms of emission and particle characteristics. Its affordability and disposable design may enhance accessibility, particularly in resource-limited settings.</p>

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Evaluating a Novel Card-based Spacer (MDI Plus®) Against Conventional Aerochamber Plus® for Salbutamol Delivery: An In-vitro Study

  • 期刊论文

  • 发表日期：

    2025年12月3日

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  • Haitham Saeed,
  • Wesam G. Ammari,
  • Marina E. Boules,
  • Hasnaa Osama,
  • Mohamed AbdElrahman,
  • Saleh Alghamdi,
  • Maha F. Mohamed,
  • Basma ME Mohamed,
  • Mohammed A. Amin,
  • Mina Nicola,
  • Hadeer S. Harb,
  • Mohamed E. A. Abdelrahim,
  • Ahmed H.M. Sobh

摘要

Background

Correct pressurized metered dose inhaler (pMDI) technique is essential for optimal lung deposition. Although spacer devices are recommended for patients with poor inhaler technique, access and affordability remain barriers. The current research evaluated the in-vitro salbutamol aerosol delivery characteristics through a novel card-based spacer (the MDI Plus®), compared to a commercial plastic spacer (AeroChamber Plus®).

Method

An Andersen cascade impactor was used to assess the total emitted dose (TED) and aerodynamic particle size distribution (APSD) of salbutamol emitted from pMDI alone and pMDI attached to two different spacers: the MDI Plus® and AeroChamber Plus®. Key APSD metrics included fine particle dose (FPD), fine particle fraction (FPF), mass median aerodynamic diameter (MMAD), and geometric standard deviation (GSD). Salbutamol samples were quantified using a validated high-performance liquid chromatography method.

Results

pMDI alone produced the highest total emitted dose (TED: 368.35 ± 20.26 µg), significantly exceeding AeroChamber Plus® (207.32 ± 6.39 µg) and MDI Plus® (193.53 ± 3.18 µg) (p < 0.001). MDI Plus® had the highest fine particle fraction (FPF: 71.41 ± 3.12%) compared to AeroChamber Plus® (58.75 ± 0.89%) and pMDI alone (24.73 ± 2.74%), p = 0.051. MMAD was lowest with MDI Plus® (3.88 ± 0.02 μm), suggesting smaller, more respirable particles. Both spacers reduced upper airway deposition relative to pMDI alone.

Conclusion

The current findings support the utility of spacers in optimizing pMDI aerosol delivery. The MDI Plus® performed comparably to the AeroChamber Plus® in terms of emission and particle characteristics. Its affordability and disposable design may enhance accessibility, particularly in resource-limited settings.