Determination of parameters related to nasal inspiratory pressures in children utilizing valved- holding chambers (valved spacers) Rita Krumenauer a, * , Se ´rgioLuisAmante´a b , Jose´Faibes Lubianca Neto a , Ana Paula Brasil a , Rosane Reginato b , Alexandre Vontobel Padoin a a Department of Otorhinolaryngology, Santo Antonio Children’s Hospital, Complexo Hospitalar Santa Casa de Porto Alegre, Brazil b Department of Pediatry, Santo Antonio Children’s Hospital, Complexo Hospitalar Santa Casa de Porto Alegre, Brazil Received 24 October 2008; received in revised form 25 November 2008; accepted 27 November 2008 Available online 14 January 2009 International Journal of Pediatric Otorhinolaryngology (2009) 73, 451—456 www.elsevier.com/locate/ijporl KEYWORDS Allergic rhinitis; Asthma; Treatment; Children; Inhalation therapy; Valved spacers Summary Objective: The administration of medication by the nasal route using valved spacers, may be an alternative for the concomitant treatment of allergic rhinitis and asthma. The aim of this study was to determine if children are capable, in using a spacer and face mask, of opening the inspiratory valve using only nasal inhalation. Methods: Prospective cross-sectional. The study included 85 children aged 4—9 years. Four types of valved spacers connected to a digital vacuum manometer were evaluated. The patients were prompted to inhale through their nose and the pressure reached in the first curve, maximal peak and time between the start of the inspiratory action and the first effective inspiration (opening of the valve) were determined. The results were compared with factors such as age, weight, BMI, gender, and presence of rhinitis or asthma. Results: In two of the spacers, the valve opened in 98.8% of the tests with nasal inspiration only. The spacer ACE 1 holding chamber showed initial and maximal inspiratory pressures that were significantly greater than with the others ( p < 0.001). No correlation was observed between the parameters examined for each spacer and the patient variables considered. Conclusion: The results suggest that children 4—9 years old are able to open the spacer valve with only nasal inspiration. The spacer ACE 1 holding chamber was shown to be significantly more effective than the others tested. Studies that demonstrate that air inspired nasally reaches the lungs effectively are Abbreviations: SPSS, Statistical Package for the Social Sciences. * Corresponding author at: Av. Independe ˆncia 50/806, 90035-070 Porto Alegre, RS, Brazil. Tel.: +55 5198243455; fax: +55 5135934247. E-mail address: ritak@cpovo.net (R. Krumenauer). 0165-5876/$ — see front matter # 2008 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijporl.2008.11.009