Make every puff count - The Impact of different Valved Holding Chambers (VHCs) on Carbon Footprint of MDIs.

15 May 2023
Objective: Using a Functional Respiratory Imaging (FRI) study we compare the modelled lung delivery of rescue medication via different valved spacers with the goal of providing optimum patient care and minimizing potential carbon footprint. Methods: FRI was applied to a 67-year-old male COPD Stage III patient. Drug delivery and airway deposition of MDI delivered albuterol was modelled using FRI with and without three VHCs (AeroChamber Plus* Flow-Vu*, ACPlusFV; OptiChamber Diamond, OD; Compact Space Chamber Plus, CSCP). For the MDI alone, in addition to the ‘perfect coordination’ 0 second delay, a short inhalation delay of 0.5 seconds was evaluated. For the MDI/VHC systems, a typical 2 second delay was evaluated. Drug delivery was then equated to a potential relative carbon footprint based upon published claims that Ventolin has a carbon footprint of 28 kg CO2 per inhaler. Results: Lung deposition results (mcg) Table 1 Concusions: Inhalation delay can have a very significant impact on delivery when using the MDI alone, potentially requiring multiple additional actuations in order to get symptom relief. Significant differences were also observed between the spacers, with intrathoracic delivery for the AeroChamber Plus* Flow-Vu* VHC system being almost double that of the other two spacers. The reduced drug delivery from the comparator spacers could necessitate an additional actuation (puff) from the inhaler. By maximizing the amount of each puff reaching the lungs, through use of the AeroChamber Plus* Flow-Vu* spacer, the patient is likely to be able to get relief sooner and reduce the number of puffs required, thereby reducing carbon footprint.

Resource information

Respiratory conditions
  • Asthma
Respiratory topics
  • Green Issues
  • Treatment - drug
Type of resource
Munich 2023
Jem Patel1, Jason Suggett2, Mark Nagel2 1Trudell Medical UK, Basingstoke, United Kingdom, 2Trudell Medical International, London, Canada