When Should a Spacer Be Used

Detennining the suitability of various devices for different patients will improve the response to dmg therapy and thus ultimately improve the treatment of asthma. 

The use of a spacer improves the safety of treattnent with a pMDI corn- 

Face masks should be used with spacers unless it is certain that the patient will not entrain though the nose or aronnd the monthpiece. This is often difficult to confirm in young children, who shonld therefore nse face masks in most cases nntil abont the age of 4 years, after which a monthpiece should be used. The age at which devices such as DPIs, requiring active cooperation, may be used depends on the individual patient. It shonld be anphasized that the choice of device should not be based on the physical ability to achieve certain inhalation flows but rather on the maturity and willingness of the patient to comply under aU conditions. Young children can often use more demanding devices correctly under optimal conditions but may not do so at aU times, particularly during res- 

Marcel Dekker, Inc. 270 Madison Avenue, New York, New York 10016 

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