J Korean Geriatr Soc.  2004 Dec;8(4):228-232.

The Effect of Spacer on the Bronchodilator Response in the First Medical Examination of Old Age

• Lee YD
• Sin SK
• Cho YS
• Han MS

Abstract

BACKGROUNDS: When measuring lung function and response to bronchodilator, MDI(metered-dose inhaler) is commonly used but unfamiliarity of its use and cold sensation by the puffed gas decrease reliability of the result. Spacer can reduce the cold freon effect and undesired oropharyngeal deposition caused by the rapid evaporation of the propellant and there are many studies which showed more effectiveness of spacer on the treatment of children with asthma but no study whether it is effective on the bronchodilator response test in the first medical examination of old age. Therefore, we tested whether the use of spacer can reduce the cold freon effect and improve the bronchodilator response in the first medical examination of old age.
METHODS
Two hundred of elderly patients( 65years) who had never used MDI were measured the bronchodilator response. Subjects were randomised to either spacer-user or spacer-nonuser. Twenty minutes after 400 g fenoterol was administered, FEV1 (forced expiratory volume in one second) was measured. Bronchoconstriction was defined as a decrease in FEV1 by 10% or greater after bronchodilator inhalation. We further devided each group into normal or obstructive group, obstructive group was defined as FEV1<80% of predicted and FEV1/FVC<70%.
RESULTS
In normal group, spacer-user(n=83) showed greater bronchodilator response than spacer-nonuser(n=66), 6.43% vs 3.81% respectively(p<0.05) and two case of bronchoconstriction occured only in spacer-nonuser. In obstructive group, there is no significant difference in bronchodilator response between spacer-user(n=18) and spacer-nonuser(n=33), 12.32% vs 11.16% respectively(p>0.05) but brochoconstriction(n=1) occured only in spacer-nonuser.
CONCLUSION
Spacer improved bronchodilator response and prevented bronchoconstriction, in the first medical examination of old age.

MeSH Terms

Aged
Asthma
Bronchoconstriction
Child
Chlorofluorocarbons
Fenoterol
Humans
Inhalation
Lung
Sensation
Chlorofluorocarbons
Fenoterol