Abstract
Background: During the COVID‐19 pandemic, a metered‐dose inhaler (MDI) with a
valved holding chamber (VHC) is a preferred route of bronchodilator delivery. We
have developed a new homemade VHC, made of a paper coffee cup, and a drinking
water bottle. This study was conducted to compare the bronchodilator response in
children with airway hyperresponsiveness after the use of our homemade VHC and
that of a standard commercial one.

Methods: In a randomized, two‐period, two‐sequence crossover trial, we recruited
20 children, aged 6‐15 years, who had a greater than 12% increase in FEV1 after
inhaled salbutamol. They were randomized into Group A and B. Group A used our
VHC on the first day and Aerochamber® on the second day. Group B used the same
VHCs but in alternate sequence. Spirometries were performed before and after
400 μg of salbutamol, MDI was administered via those VHCs.

Results: Baseline demographic data and spirometric values did not have statistically
significant differences between group A and B and between the first and second day
(p > .05). After giving salbutamol MDI, both VHCs produced significant increases in
FVC, FEV1, and FEF25‐75% (p < .005). The improvement in FEV1 did not significantly
differ between our homemade VHC and Aerochamber® (p > .05).

Conclusion: Our homemade VHC is effective for an MDI bronchodilator delivery.
Since it is very cheap and easy to make, it may be used as a disposable device to
minimize airborne transmission especially when commercial VHC is not available.