{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:52:18Z","timestamp":1786978338252,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100009050","name":"Tampereen Lastenklinikan Tuki Ry","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is a scarcity of high\u2010quality research on the efficient delivery of inhaled corticosteroids using valved holding chambers (VHCs) in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The delivered dose (DD) of fluticasone from a metered dose inhaler (pMDI) was tested using four VHCs: AeroChamber plus Flow\u2010Vu (AC), Babyhaler (BH), EasyChamber (EC), and Optichamber Diamond (OD). The in vitro setup included an anatomical child throat model, Next Generation Impactor, and a breathing simulator to generate tidal breathing of a four and a 6\u2010year\u2010old child, and adult type single inhalation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>OD showed the lowest proportion of fluticasone trapped in the throat with all breathing patterns. AC showed similar fine particle dose (FPD) in the respirable range (1\u20135\u2009\u00b5m) irrespective of the breathing pattern. For BH, the median FPD 1\u20135\u2009\u00b5m was highest during adult breathing. OD and EC showed higher overall DD and higher doses in the 1\u20135\u2009\u00b5m range with paediatric breathing profiles compared to adult inhalation. The median DD and FPD 1\u20135\u2009\u00b5m were significantly lower with BH compared to any other VHCs during tidal breathing. Compared to EC, the FPD of the other VHCs were skewed towards &lt;2\u2009\u00b5m particles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Fluticasone delivery is markedly affected by breathing pattern and VHC model. The observed differences in throat deposition and FPD delivered may have significant clinical implications for side effects and controlling airway inflammation. All VHCs intended for paediatric use should undergo testing using internationally recognised standardised methods incorporating clinically relevant paediatric breathing patterns.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.27300","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T09:53:26Z","timestamp":1727690006000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Inhaled corticosteroid delivery is markedly affected by breathing pattern and valved holding chamber model"],"prefix":"10.1002","volume":"60","author":[{"given":"Laura","family":"Ojanper\u00e4","sequence":"first","affiliation":[{"name":"Centre for Child Health Research Tampere University Arvo Ylp\u00f6n katu 34 Tampere 33520 Finland"},{"name":"Tampere University Hospital Kalevantie 4 Tampere 33014 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauri","family":"Lehtim\u00e4ki","sequence":"additional","affiliation":[{"name":"Tampere University Hospital Kalevantie 4 Tampere 33014 Finland"},{"name":"Faculty of Medicine and Health Technology Tampere University Arvo Ylp\u00f6n katu 34 Tampere 33520 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heini","family":"Huhtala","sequence":"additional","affiliation":[{"name":"Faculty of Social Sciences, Tampere University Arvo Ylp\u00f6n katu 34 Tampere 33520 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter","family":"Csonka","sequence":"additional","affiliation":[{"name":"Centre for Child Health Research Tampere University Arvo Ylp\u00f6n katu 34 Tampere 33520 Finland"},{"name":"Terveystalo Healthcare Rautatienkatu 27 Tampere 33100 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2004.00526.x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.127.1.335"},{"key":"e_1_2_11_4_1","unstructured":"Global Initiative for Asthma. 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