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                          "etal" => false
                          "autores" => array:1 [
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                        "paginaInicial" => "276"
                        "paginaFinal" => "284"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3893919"
                            "web" => "Medline"
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                      "titulo" => "Reported clinical experiences with inhaled terbutaline aerosol via spacer devices"
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                          "autores" => array:1 [
                            0 => "E&#46;R&#46; Weeke"
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                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Respir Dis"
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                        "numero" => "Suppl"
                        "paginaInicial" => "105"
                        "paginaFinal" => "109"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Terbutaline aerosol from a metered dose inhaler with a 750 ml spacer or as a nebulized solution"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
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                            1 => "K&#46;G&#46; Hidinger"
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                    0 => array:1 [
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                        "tituloSerie" => "Respiration"
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                        "paginaInicial" => "237"
                        "paginaFinal" => "240"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6857008"
                            "web" => "Medline"
                          ]
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            13 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of a 750 ml spacer and a nebulizer in domiciliary treatment of severe chronic asthma with terbutaline"
                      "autores" => array:1 [
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                          "etal" => false
                          "autores" => array:4 [
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                            1 => "E&#46;P&#46; Munch"
                            2 => "E&#46; Weeke"
                            3 => "K&#46;G&#46; Hidinger"
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
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                        "paginaInicial" => "498"
                        "paginaFinal" => "503"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6628585"
                            "web" => "Medline"
                          ]
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                    0 => array:2 [
                      "titulo" => "Comparison of three techniques of inhalation on the airway response to terbutaline"
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                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;J&#46; Cushley"
                            1 => "R&#46;A&#46; Lewis"
                            2 => "A&#46;E&#46; Tattersfield"
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
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                        "volumen" => "38"
                        "paginaInicial" => "908"
                        "paginaFinal" => "913"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6665750"
                            "web" => "Medline"
                          ]
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              "identificador" => "bib0080"
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              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "A comparison of three means of pressurized aerosol inhaler use"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46;W&#46; Epstein"
                            1 => "J&#46;E&#46; Parsons"
                            2 => "P&#46;N&#46; Corey"
                            3 => "G&#46;H&#46; Worsley"
                            4 => "P&#46;A&#46; Reilly"
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                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/arrd.1983.128.2.253"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1983"
                        "volumen" => "128"
                        "paginaInicial" => "253"
                        "paginaFinal" => "255"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6881687"
                            "web" => "Medline"
                          ]
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                      ]
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                ]
              ]
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            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical trial of a modified inhaler for pressurized aerosols"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K&#46;G&#46; Hidinger"
                            1 => "J&#46; Perk"
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                      ]
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                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Clin Pharmacol"
                        "fecha" => "1981"
                        "volumen" => "20"
                        "paginaInicial" => "109"
                        "paginaFinal" => "111"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7021163"
                            "web" => "Medline"
                          ]
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                ]
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            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An objective assesment of the tube spacer in patients unable to use a conventional pressurized aerosol efficiently"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;J&#46; Godden"
                            1 => "G&#46;K&#46; Crompton"
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                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dis Chest"
                        "fecha" => "1981"
                        "volumen" => "75"
                        "paginaInicial" => "165"
                        "paginaFinal" => "168"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7272197"
                            "web" => "Medline"
                          ]
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                ]
              ]
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            18 => array:3 [
              "identificador" => "bib0095"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A tube spacer to improve inhalation of drugs from pressurized aerosols"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Bloomfield"
                            1 => "G&#46;K&#46; Crompton"
                            2 => "N&#46;J&#46;P&#46; Winsey"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Br Med J"
                        "fecha" => "1979"
                        "volumen" => "2"
                        "paginaInicial" => "1479"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/526821"
                            "web" => "Medline"
                          ]
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                    ]
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                ]
              ]
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            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical trial of two inhalation techniques for pressurized aerosols"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Stauder"
                            1 => "K&#46;G&#46; Hidinger"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Int Med Res"
                        "fecha" => "1980"
                        "volumen" => "8"
                        "paginaInicial" => "217"
                        "paginaFinal" => "220"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6993253"
                            "web" => "Medline"
                          ]
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                ]
              ]
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            20 => array:3 [
              "identificador" => "bib0105"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spirometric reference values from a mediterranean population"
                      "autores" => array:1 [
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                          "etal" => false
                          "autores" => array:8 [
                            0 => "J&#46; Roca"
                            1 => "J&#46; Sanchis"
                            2 => "A&#46; Agust&#237;-Vidal"
                            3 => "F&#46; Segarra"
                            4 => "D&#46; Navajas"
                            5 => "R&#46; Rodr&#237;guez-Roisin"
                            6 => "P&#46; Casan"
                            7 => "S&#46; Sans"
                          ]
                        ]
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Bull Eur Physiopathol Respir"
                        "fecha" => "1986"
                        "volumen" => "22"
                        "paginaInicial" => "217"
                        "paginaFinal" => "224"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3730638"
                            "web" => "Medline"
                          ]
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                ]
              ]
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            21 => array:3 [
              "identificador" => "bib0110"
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                    0 => array:2 [
                      "titulo" => "Normativa para la espirometr&#237;a forzada&#46; Recomendaciones SEPAR n&#46; &#176; 1"
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                          "colaboracion" => "Sociedad Espa&#241;ola de Patolog&#237;a del Aparato&#44; Respiratorio&#44; Grupo de trabajo para la pr&#225;ctica de la espirometr&#237;a en cl&#237;nica"
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                      "Libro" => array:2 [
                        "fecha" => "1984"
                        "editorial" => "Ed Doyma"
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                ]
              ]
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            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multivariate statistical methods"
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                          "etal" => false
                          "autores" => array:1 [
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                        "edicion" => "2&#46;<span class="elsevierStyleSup">a</span> ed"
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                ]
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            23 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines for assesing bronchodilator response"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
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                    0 => array:2 [
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                      "Revista" => array:5 [
                        "tituloSerie" => "Am Rev Respir Dis"
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                        "paginaInicial" => "95"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7065514"
                            "web" => "Medline"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Clinical evaluation of a simple demand inhalation MDI aerosol delivery device"
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                          "etal" => false
                          "autores" => array:4 [
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                    0 => array:1 [
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                        "paginaFinal" => "41"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6861546"
                            "web" => "Medline"
                          ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Improvement of pressurized aerosol deposition with Nebuhaler spacer device"
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                          "etal" => false
                          "autores" => array:5 [
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                            1 => "A&#46;B&#46; Millar"
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                            3 => "F&#46; Moren"
                            4 => "S&#46;W&#46; Clarke"
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
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                        "paginaFinal" => "941"
                        "link" => array:1 [
                          0 => array:2 [
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                            "web" => "Medline"
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                0 => array:2 [
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                      "titulo" => "Use of spacers to facilitate inhaled corticosteroid treatment of asthma"
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                          "etal" => false
                          "autores" => array:4 [
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/arrd.1984.129.5.723"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1984"
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                        "paginaInicial" => "723"
                        "paginaFinal" => "729"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6721271"
                            "web" => "Medline"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "The efficacy of drug delivery by a pear-shaped spacer and metered dose inhaler"
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                          "autores" => array:4 [
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dis Chest"
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                        "paginaInicial" => "383"
                        "paginaFinal" => "387"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6487528"
                            "web" => "Medline"
                          ]
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              "identificador" => "bib0145"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of an extension tube on the bronchodilator efficacy of terbutaline delivered from a metered dose inhaler"
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                          "etal" => false
                          "autores" => array:4 [
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                            2 => "N&#46;J&#46;P&#46; Winsey"
                            3 => "T&#46;B&#46; Stretton"
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
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                        "volumen" => "35"
                        "paginaInicial" => "552"
                        "paginaFinal" => "556"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7001671"
                            "web" => "Medline"
                          ]
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              "identificador" => "bib0150"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of an extension tube on the bronchodilator efficacy of terbutaline delivered from a metered dose inhaler"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
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                            2 => "K&#46;G&#46; Hidinger"
                            3 => "M&#46; Van Der Straeten"
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                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Respiration"
                        "fecha" => "1984"
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                        "paginaInicial" => "61"
                        "paginaFinal" => "66"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6689799"
                            "web" => "Medline"
                          ]
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                      ]
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                ]
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            30 => array:3 [
              "identificador" => "bib0155"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of different extension actuator tubes on the bronchodilation effect of a terbutaline sulfate aerosol"
                      "autores" => array:1 [
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Vol. 23. Issue 3.
Pages 118-122 (May - June 1987)
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Vol. 23. Issue 3.
Pages 118-122 (May - June 1987)
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Camara de aerosol para pacientes con inhalacion incorrecta
Aerosol holding chamber for patients with faulty inhalation technique
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3574
M. Mayos, P. Casan, J.L. Heredia, J. Sanchis
Laboratori Funció Pulmonar. Hospital de la Sta. Creu i de Sant Pau. Barcelona
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La respuesta espirométrica al salbutamol inhalado desde un cartucho presurizado se comparó a la de la inhalación con ayuda de una cámara de aerosol (CA) en 26 pacientes con limitación al flujo aéreo, mediante un diseño doble ciego cruzado. Cinco de los pacientes se excluyeron del análisis por la excesiva variación de su espirometría basal durante el estudio. En 10 de los 21 restantes la técnica inhalatoria era muy defectuosa. En estos 10, el incremento sobre el valor basal a los 10 min de la inhalación desde el cartucho fue 254±172ml (NS) en la FVC y 113±172 ml (NS) en el FEV1; tras inhalar con ayuda de la CA, el aumento fue de 409±267ml (p < 0,001) en la FVC y de 237±160ml (p < 0,001) en el FEV1. En los 11 restantes y en el total de 21 pacientes el aumento post-inhalación fue significativo en las dos ocasiones. Los datos apoyan la utilidad de la CA en los enfermos con dificultad para la correcta inhalación de aeorosoles generados por cartucho presurizado.

Spirometric differences in the effect of salbutamol inhaled from a metered dose inhaler (MDI) with and without an aerosol Holding diamber (AHC) were investigated in 26 patients with airflow iimitation. The study design was double blind, randomised and placebo controlled. Patients were selected because their regularly faulty inhalation technique. Five of them were excluded from the analysis because their basal FEV1 value varied ≥ 15% during the study period. In of the 21 remaining patients, the inhalation manoeuvre was very poor. In 10 them, the mean postsalbutamol change was 254±172ml (NS) for the FVC and 113±172ml (NS) for the FEV1. When the inhalation was performed with the AHC, mean post-salbutamol changes were 409±267ml (p < 0.001) for the FVC and 237±160ml (p <0.001) for the FEV1. As opposed to these, mean changes in the whole group of 21 patients were significant for both inhalations, with and without the AHC. The data of the present study support the usefulness of the AHC in patients with poor inhalation technique.

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Bibliografía
[1.]
S.P. Newman, S.W. Clarke.
Therapeutic aerosols I — Physical and practical considerations.
Thorax, 38 (1983), pp. 881-886
[2.]
S.P. Newman.
Aerosol deposition considerations in inhalation therapy.
Chest, 88 (1985), pp. 152-160
[3.]
S.P. Newman, F. Moren, D. Pavia, N.F. Sheahan, S.W. Clarke.
Deposition of pressurized aerosols in the human respiratory tract.
Thorax, 36 (1981), pp. 52-55
[4.]
I.C. Paterson, G.K. Crompton.
Use of pressurized aerosols by asthmatic patients.
Br Med J, 1 (1976), pp. 76-77
[5.]
S.C. Allen, A. Prior.
What determines whether an elderly patient can use a metered dose inhaler correctly?.
Br J Dis Chest, 80 (1986), pp. 45-49
[6.]
G.K. Crompton.
Problems patients have using pressurized aerosol inhalers.
Eur J Respir Dis, 63 (1982), pp. 101-104
[7.]
J. Orehek, P. Gayrard, C. Grimaud, J. Charpin.
Patient error in use of bronchodilator metered aerosols.
Br Med J, 1 (1976), pp. 76
[8.]
S.P. Newman, D. Pavia, S.W. Clarke.
How should a pressurized adrenergic bronchodilator be inhaled?.
Eur J Respir Dis, 62 (1981), pp. 3-21
[9.]
S.P. Newman, D. Pavia, N. Garland, S.W. Clarke.
Effects of various inhalation modes on the deposition of radioactive pressurized aerosols.
Eur J Respir Dis, 63 (1982), pp. 57-65
[10.]
F. Moren.
Drug deposition of pressurized inhalation aerosol. Influence of actuator tube design.
Int J Pharm, 1 (1978), pp. 205-212
[11.]
P. Köning.
Spacer devices used with metered-dose inhalers. Breakthrough or gimmick?.
Chest, 88 (1985), pp. 276-284
[12.]
E.R. Weeke.
Reported clinical experiences with inhaled terbutaline aerosol via spacer devices.
Eur J Respir Dis, 63 (1982), pp. 105-109
[13.]
J. Stauder, K.G. Hidinger.
Terbutaline aerosol from a metered dose inhaler with a 750 ml spacer or as a nebulized solution.
Respiration, 44 (1983), pp. 237-240
[14.]
L.C. Laursen, E.P. Munch, E. Weeke, K.G. Hidinger.
Comparison of a 750 ml spacer and a nebulizer in domiciliary treatment of severe chronic asthma with terbutaline.
Eur J Respir Dis, 64 (1983), pp. 498-503
[15.]
M.J. Cushley, R.A. Lewis, A.E. Tattersfield.
Comparison of three techniques of inhalation on the airway response to terbutaline.
Thorax, 38 (1983), pp. 908-913
[16.]
S.W. Epstein, J.E. Parsons, P.N. Corey, G.H. Worsley, P.A. Reilly.
A comparison of three means of pressurized aerosol inhaler use.
Am Rev Respir Dis, 128 (1983), pp. 253-255
[17.]
K.G. Hidinger, J. Perk.
Clinical trial of a modified inhaler for pressurized aerosols.
Eur J Clin Pharmacol, 20 (1981), pp. 109-111
[18.]
D.J. Godden, G.K. Crompton.
An objective assesment of the tube spacer in patients unable to use a conventional pressurized aerosol efficiently.
Br J Dis Chest, 75 (1981), pp. 165-168
[19.]
P. Bloomfield, G.K. Crompton, N.J.P. Winsey.
A tube spacer to improve inhalation of drugs from pressurized aerosols.
Br Med J, 2 (1979), pp. 1479
[20.]
J. Stauder, K.G. Hidinger.
Clinical trial of two inhalation techniques for pressurized aerosols.
J Int Med Res, 8 (1980), pp. 217-220
[21.]
J. Roca, J. Sanchis, A. Agustí-Vidal, F. Segarra, D. Navajas, R. Rodríguez-Roisin, P. Casan, S. Sans.
Spirometric reference values from a mediterranean population.
Bull Eur Physiopathol Respir, 22 (1986), pp. 217-224
[22.]
Sociedad Española de Patología del Aparato, Respiratorio, Grupo de trabajo para la práctica de la espirometría en clínica.
Normativa para la espirometría forzada. Recomendaciones SEPAR n. ° 1.
Ed Doyma, (1984),
[23.]
D.F. Morrison.
Multivariate statistical methods.
2.a ed, McGraw-Hill Book Co, (1976),
[24.]
J.J. Marini.
Guidelines for assesing bronchodilator response.
Am Rev Respir Dis, 125 (1982), pp. 95
[25.]
M. Dolovich, R. Ruffin, D. Corr, M.T. Newhouse.
Clinical evaluation of a simple demand inhalation MDI aerosol delivery device.
Chest, 84 (1983), pp. 36-41
[26.]
S.P. Newman, A.B. Millar, T.R. Lennard Jones, F. Moren, S.W. Clarke.
Improvement of pressurized aerosol deposition with Nebuhaler spacer device.
Thorax, 39 (1984), pp. 935-941
[27.]
J.H. Toogood, B. Jennings, J. Baskerville, S.A. Johansson.
Use of spacers to facilitate inhaled corticosteroid treatment of asthma.
Am Rev Respir Dis, 129 (1984), pp. 723-729
[28.]
J. Morris, J.S. Milledge, H. Moszoro, A. Higgins.
The efficacy of drug delivery by a pear-shaped spacer and metered dose inhaler.
Br J Dis Chest, 78 (1984), pp. 383-387
[29.]
S.A. Gomm, N.P. Keaney, N.J.P. Winsey, T.B. Stretton.
Effect of an extension tube on the bronchodilator efficacy of terbutaline delivered from a metered dose inhaler.
Thorax, 35 (1980), pp. 552-556
[30.]
R. Pauwels, H. Lamont, K.G. Hidinger, M. Van Der Straeten.
Influence of an extension tube on the bronchodilator efficacy of terbutaline delivered from a metered dose inhaler.
Respiration, 45 (1984), pp. 61-66
[31.]
J. Lulling, J.P. Delwiche, K.G. Hidinger, J. Prionot.
Influence of different extension actuator tubes on the bronchodilation effect of a terbutaline sulfate aerosol.
Eur J Respir Dis, 64 (1983), pp. 33-37
[32.]
S.B. Lindgren, H. Formoren, F. Moren.
Improved aerosol therapy of asthma: effect of actuator tube size on drug availability.
Eur J Respir Dis, 61 (1980), pp. 56-61
Copyright © 1987. Sociedad Española de Neumología y Cirugía Torácica
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