{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T21:51:56Z","timestamp":1789681916991,"version":"4.0.1"},"reference-count":60,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[1985,8,1]],"date-time":"1985-08-01T00:00:00Z","timestamp":491702400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Chest"],"published-print":{"date-parts":[[1985,8]]},"DOI":"10.1378\/chest.88.2.276","type":"journal-article","created":{"date-parts":[[2007,11,7]],"date-time":"2007-11-07T18:25:26Z","timestamp":1194459926000},"page":"276-284","source":"Crossref","is-referenced-by-count":120,"title":["Spacer Devices Used with Metered-Dose Inhalers"],"prefix":"10.1016","volume":"88","author":[{"given":"Peter","family":"K\u00f6nig","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1378\/chest.88.2.276_bib1","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1136\/thx.36.1.52","article-title":"Deposition of pressurised aerosols in the human respiratory tract","volume":"36","author":"Newman","year":"1981","journal-title":"Thorax"},{"key":"10.1378\/chest.88.2.276_bib2","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/0091-6749(80)90200-6","article-title":"Candidiasis and dysphonia complicating beclomethasone treatment of asthma","volume":"65","author":"Toogoood","year":"1980","journal-title":"J Allergy Clin Immunol"},{"key":"10.1378\/chest.88.2.276_bib3","first-page":"273","article-title":"Synchronization of bronchodilator release","volume":"217","author":"Coady","year":"1976","journal-title":"Practitioner"},{"key":"10.1378\/chest.88.2.276_bib4","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1136\/bmj.1.6001.76","article-title":"Patient error in use of bronchodilator metered aerosols","volume":"1","author":"Orehek","year":"1976","journal-title":"Br Med J"},{"key":"10.1378\/chest.88.2.276_bib5","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1136\/bmj.1.5441.1037","article-title":"Misuse of inhaled bronchodilator agents","volume":"1","author":"Saunders","year":"1965","journal-title":"Br Med J"},{"key":"10.1378\/chest.88.2.276_bib6","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1136\/bmj.1.6001.76-a","article-title":"Use of pressurised aerosols by asthmatic patients","volume":"1","author":"Paterson","year":"1976","journal-title":"Br Med J"},{"key":"10.1378\/chest.88.2.276_bib7","first-page":"1135","article-title":"Faulty use of canister nebulizers for asthma","volume":"14","author":"Appel","year":"1982","journal-title":"J Family Prac"},{"key":"10.1378\/chest.88.2.276_bib8","first-page":"489","article-title":"Inhalation devices","volume":"63","author":"Crompton","year":"1982","journal-title":"Eur J Respir Dis"},{"key":"10.1378\/chest.88.2.276_bib9","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1378\/chest.84.1.36","article-title":"Clinical evaluation of a simple demand inhalation MDI aerosol delivery device","volume":"84","author":"Dolovich","year":"1983","journal-title":"Chest"},{"key":"10.1378\/chest.88.2.276_bib10","first-page":"317","article-title":"Deposition of pressurized suspension aerosols inhaled through extension devices","volume":"124","author":"Newman","year":"1981","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.88.2.276_bib11","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/0378-5173(78)90009-1","article-title":"Drug deposition of pressurized inhalation aerosols: 1. influence of actuator tube design","volume":"1","author":"Moren","year":"1978","journal-title":"Int J Pharm"},{"key":"10.1378\/chest.88.2.276_bib12","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/0007-0971(81)90049-8","article-title":"An objective assessment of the tube spacer in patients unable to use a conventional pressurized aerosol efficiently","volume":"75","author":"Godden","year":"1981","journal-title":"Br J Dis Chest"},{"key":"10.1378\/chest.88.2.276_bib13","first-page":"253","article-title":"A comparison of three means of pressurized aerosol inhaler use","volume":"128","author":"Epstein","year":"1983","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.88.2.276_bib14","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/BF00607145","article-title":"Clinical trial of a modified inhaler for pressurized aerosols","volume":"20","author":"Hidinger","year":"1981","journal-title":"Eur J Clin Pharmacol"},{"key":"10.1378\/chest.88.2.276_bib15","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1177\/030006058000800306","article-title":"Clinical trial of two inhalation techniques for pressurized aerosols","volume":"8","author":"Stauder","year":"1980","journal-title":"J Int Med Res"},{"key":"10.1378\/chest.88.2.276_bib16","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1136\/bmj.2.6203.1479","article-title":"A tube spacer to improve inhalation of drugs from pressurised aerosols","volume":"2","author":"Bloomfield","year":"1979","journal-title":"Br Med J"},{"key":"10.1378\/chest.88.2.276_bib17","first-page":"498","article-title":"Long-term effects of a tube extension on bronchodilator treatment with pressurized aerosol","volume":"63","author":"Langaker","year":"1982","journal-title":"Eur J Respir Dis"},{"key":"10.1378\/chest.88.2.276_bib18","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1016\/S0140-6736(80)92505-2","article-title":"Influence of tube-spacer on aerosol efficacy","volume":"2","author":"Spicer","year":"1980","journal-title":"Lancet"},{"key":"10.1378\/chest.88.2.276_bib19","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1007\/BF00609623","article-title":"Terbutaline aerosol from a metered dose inhaler via a 750 ml spacer","volume":"22","author":"Dorow","year":"1982","journal-title":"Eur J Clin Pharmacol"},{"key":"10.1378\/chest.88.2.276_bib20","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1159\/000194599","article-title":"Influence of an extension tube on the bronchodilator efficacy of terbutaline delivered from a metered dose inhaler","volume":"45","author":"Pauwels","year":"1984","journal-title":"Respiration"},{"key":"10.1378\/chest.88.2.276_bib21","first-page":"337","article-title":"Terbutaline from an ordinary pressurized aerosol or via a 750 ml spacer: a comparative long-term trial in two 4-week periods","volume":"35","author":"Hidinger","year":"1984","journal-title":"Curr Ther Res"},{"key":"10.1378\/chest.88.2.276_bib22","first-page":"33","article-title":"Influence of different extension-actuator tubes on the bronchodilation effect of a terbutaline sulfate aerosol","volume":"64","author":"Lulling","year":"1983","journal-title":"Eur J Respir Dis"},{"key":"10.1378\/chest.88.2.276_bib23","first-page":"56","article-title":"Improved aerosol therapy of asthma: effect of actuator tube size on drug availability","volume":"61","author":"Lindgren","year":"1980","journal-title":"Eur J Respir Dis"},{"key":"10.1378\/chest.88.2.276_bib24","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1136\/thx.38.12.908","article-title":"Comparison of three techniques of inhalation on the airway response to terbutaline","volume":"38","author":"Cushley","year":"1983","journal-title":"Thorax"},{"key":"10.1378\/chest.88.2.276_bib25","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1111\/j.1398-9995.1980.tb01813.x","article-title":"A new inhalation technique for Freon aerosols: terbutaline aerosol with a tube extension in a 2-day crossover comparison with sulbutamol aerosol","volume":"35","author":"Eriksson","year":"1980","journal-title":"Allergy"},{"key":"10.1378\/chest.88.2.276_bib26","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1136\/thx.35.7.552","article-title":"Effect of an extension tube on the bronchodilator efficacy of terbutaline delivered from a metered dose inhaler","volume":"35","author":"Gomm","year":"1980","journal-title":"Thorax"},{"key":"10.1378\/chest.88.2.276_bib27","first-page":"504","article-title":"Inhalation of terbutaline sulphate through a conventional actuator or a pear-shaped tube: effects and side effects","volume":"63","author":"Lindgren","year":"1982","journal-title":"Eur J Respir Dis"},{"key":"10.1378\/chest.88.2.276_bib28","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1111\/j.1398-9995.1983.tb02357.x","article-title":"Bronchodilation of terbutaline in small doses from a 750 ml spacer","volume":"38","author":"Munch","year":"1983","journal-title":"Allergy"},{"key":"10.1378\/chest.88.2.276_bib29","first-page":"42","article-title":"Addition of a spacer device as an alternative in treatment with a metered inhaler","volume":"130","author":"Dirksen","year":"1983","journal-title":"Eur J Respir Dis"},{"key":"10.1378\/chest.88.2.276_bib30","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1159\/000194290","article-title":"Inhalation of terbutaline spray through an extended mouthpiece","volume":"40","author":"Poppius","year":"1980","journal-title":"Respiration"},{"key":"10.1378\/chest.88.2.276_bib31","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1007\/BF00542512","article-title":"Comparative efficacy of different methods of nebulizing terbutaline","volume":"26","author":"Pedersen","year":"1983","journal-title":"Eur J Clin Pharmacol"},{"key":"10.1378\/chest.88.2.276_bib32","first-page":"111","article-title":"Pretreatment of exercise-induced asthma with terbutaline administered from pressurized aerosols and nebulizers","volume":"63","author":"Bundgaard","year":"1982","journal-title":"Eur J Respir Dis"},{"key":"10.1378\/chest.88.2.276_bib33","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1136\/thx.35.8.620","article-title":"Use of a special inhaler attachment in asthmatic children","volume":"35","author":"Ellul-Micallef","year":"1980","journal-title":"Thorax"},{"key":"10.1378\/chest.88.2.276_bib34","first-page":"47","article-title":"Improved efficacy of pressurized terbutaline aerosol in childhood asthma using a spacer","volume":"26","author":"Kjellman","year":"1981","journal-title":"Opuscula Med"},{"key":"10.1378\/chest.88.2.276_bib35","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1056\/NEJM198306023082205","article-title":"Aerosol treatment of bronchoconstriction in children, with or without a tube spacer","volume":"308","author":"Pedersen","year":"1983","journal-title":"N Engl J Med"},{"key":"10.1378\/chest.88.2.276_bib36","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/S0022-3476(84)81119-1","article-title":"Pulmonary response to a bronchodilator delivered from three inhalation devices","volume":"104","author":"Rivlin","year":"1984","journal-title":"J Pediatr"},{"key":"10.1378\/chest.88.2.276_bib37","first-page":"56","article-title":"The tube spacer in children with asthma","volume":"17","author":"Van Asperen","year":"1981","journal-title":"Aust Paediatr J"},{"key":"10.1378\/chest.88.2.276_bib38","first-page":"166","article-title":"Assessment of a new device (Aerochamber) for use with aerosol drugs in asthmatic children","volume":"50","author":"Gurwitz","year":"1983","journal-title":"Ann Allergy"},{"key":"10.1378\/chest.88.2.276_bib39","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1136\/adc.56.10.787","article-title":"Assessment of a new device for delivering aerosol drugs to asthmatic children","volume":"56","author":"Hodges","year":"1981","journal-title":"Arch Dis Child"},{"key":"10.1378\/chest.88.2.276_bib40","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1111\/j.1742-1241.1982.tb08375.x","article-title":"Terbutaline in asthmatic children: a comparison of the \u201cinhaler\u201d and \u201cspacer\u201d methods of administration","volume":"36","author":"Oliver","year":"1982","journal-title":"Br J Clin Pract"},{"key":"10.1378\/chest.88.2.276_bib41","first-page":"670","article-title":"Response to bronchodilator drug administration by a new reservoir aerosol delivery system and a review of other auxiliary delivery systems","volume":"126","author":"Tobin","year":"1982","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.88.2.276_bib42","first-page":"13","article-title":"Long-term follow-up of infants and children treated with beclomethasone aerosol by special inhalation device","volume":"45","author":"Freigang","year":"1980","journal-title":"Ann Allergy"},{"key":"10.1378\/chest.88.2.276_bib43","first-page":"272","article-title":"Peak flowmeter and spirometer mouthpieces as expansion chambers for metered dose aerosols","volume":"48","author":"Coifman","year":"1982","journal-title":"Ann Allergy"},{"key":"10.1378\/chest.88.2.276_bib44","doi-asserted-by":"crossref","first-page":"2021","DOI":"10.1136\/bmj.286.6383.2021","article-title":"Simple drug delivery system for use by young asthmatics","volume":"286","author":"Henry","year":"1983","journal-title":"Br Med J"},{"key":"10.1378\/chest.88.2.276_bib45","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1542\/peds.73.2.230","article-title":"Aerosol bag for administration of bronchodilators to young asthmatic children","volume":"73","author":"Lee","year":"1984","journal-title":"Pediatrics"},{"key":"10.1378\/chest.88.2.276_bib46","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/BF01061373","article-title":"Cumulative dose-response study comparing terbutaline pressurised aerosol administered via a pear shaped spacer and terbutaline in a nebulized solution","volume":"23","author":"Madsen","year":"1982","journal-title":"Eur J Clin Pharmacol"},{"key":"10.1378\/chest.88.2.276_bib47","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1136\/bmj.285.6345.849","article-title":"Terbutaline aerosol given through pear spacer in acute severe asthma","volume":"285","author":"Morgan","year":"1982","journal-title":"Br Med J"},{"key":"10.1378\/chest.88.2.276_bib48","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.1136\/bmj.286.6377.1548","article-title":"Pressurized aerosol with conical spacer is an effective alternative to nebuliser in chronic stable asthma","volume":"286","author":"O'Reilly","year":"1983","journal-title":"Br Med J"},{"key":"10.1378\/chest.88.2.276_bib49","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1136\/thx.37.4.300","article-title":"High-dose inhaled terbutaline in the management of chronic severe asthma: comparison of wet nebulisation and tube-spacer delivery","volume":"37","author":"Prior","year":"1982","journal-title":"Thorax"},{"key":"10.1378\/chest.88.2.276_bib50","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1159\/000194554","article-title":"Terbutaline aerosol from a metered dose inhaler with a 750 ml spacer or as a nebulized solution","volume":"44","author":"Stauder","year":"1983","journal-title":"Respiration"},{"key":"10.1378\/chest.88.2.276_bib51","first-page":"498","article-title":"Comparison of a 750 ml spacer and nebulizer in domiciliary treatment of severe chronic asthma with terbutaline","volume":"64","author":"Laursen","year":"1983","journal-title":"Eur J Respir Dis"},{"key":"10.1378\/chest.88.2.276_bib52","first-page":"113","article-title":"Assessment of a device for reducing oropharyngeal complications during beclomethasone treatment of asthma","volume":"123","author":"Tbogood","year":"1981","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.88.2.276_bib53","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1164\/arrd.1984.129.5.723","article-title":"Use of spacers to facilitate inhaled corticosteroid treatment of asthma","volume":"129","author":"Toogood","year":"1984","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.88.2.276_bib54","first-page":"108","article-title":"Meth-odological aspects on clinical trials with inhaled corticosteroids: results of two comparisons between two steroid aerosols in patients with asthma","volume":"63","author":"Bj\u00f6rkander","year":"1982","journal-title":"Eur J Resp Dis"},{"key":"10.1378\/chest.88.2.276_bib55","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/0007-0971(82)90009-2","article-title":"Comparison of twice daily administration of a new corticosteroid budesonide with beclomethasone dipropionate four times daily in treatment of chronic asthma","volume":"76","author":"Willey","year":"1982","journal-title":"Br J Dis Chest"},{"key":"10.1378\/chest.88.2.276_bib56","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1111\/j.1398-9995.1983.tb01605.x","article-title":"Nasal inhalation as a cause of inefficient pulmonal aerosol inhalation technique in children","volume":"38","author":"Pedersen","year":"1983","journal-title":"Allergy"},{"key":"10.1378\/chest.88.2.276_bib57","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1136\/bmj.288.6423.1044","article-title":"Potential limitations of a conical spacer device in severe asthma","volume":"288","author":"Cox","year":"1984","journal-title":"Br Med J"},{"issue":"119","key":"10.1378\/chest.88.2.276_bib58","first-page":"57","article-title":"Effects of various inhalation modes on the deposition of radioactive pressurized aerosols","volume":"63","author":"Newman","year":"1982","journal-title":"Eur J Respir Dis"},{"key":"10.1378\/chest.88.2.276_bib59","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1378\/chest.86.6.884","article-title":"Forced random noise resistance determination in childhood asthma","volume":"86","author":"K\u00f6nig","year":"1984","journal-title":"Chest"},{"key":"10.1378\/chest.88.2.276_bib60","first-page":"105","article-title":"Reported clinical experiences with inhaled terbutaline aerosol via spacer devices","volume":"63","author":"Weeke","year":"1982","journal-title":"Eur J Respir Dis"}],"container-title":["Chest"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0012369216396234?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0012369216396234?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2023,5,14]],"date-time":"2023-05-14T17:07:45Z","timestamp":1684084065000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0012369216396234"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1985,8]]},"references-count":60,"journal-issue":{"issue":"2","published-print":{"date-parts":[[1985,8]]}},"alternative-id":["S0012369216396234"],"URL":"https:\/\/doi.org\/10.1378\/chest.88.2.276","relation":{},"ISSN":["0012-3692"],"issn-type":[{"value":"0012-3692","type":"print"}],"subject":[],"published":{"date-parts":[[1985,8]]}}}