JAMA Pediatr

High-delivery inhaler chambers improve outcomes in young children with acute wheezing

February 25, 2026

In a randomized trial (NCT03900494) across four Finnish pediatric emergency departments, 80 children aged 6 to 48 months with moderate-to-severe wheezing were treated with albuterol using either a high‑delivery valved holding chambers (VHC) or a low‑delivery VHC. Children receiving albuterol via the high‑delivery chamber showed substantially greater reductions in respiratory distress, with posttreatment respiratory distress assessment instrument (RDAI) scores averaging 2.7 vs. 6.8 and experienced markedly lower hospitalization rates (20% vs. 50%). They were also less likely to require a fourth albuterol dose and had better physiologic recovery (lower respiratory rate, higher oxygen saturation).

Clinical takeaway: Choose high‑delivery VHCs for young children with acute wheezing to improve bronchodilator effectiveness and reduce hospitalization risk.

Source:

Csonka P, et al. (2026, February 23). JAMA Pediatr. Valved Holding Chambers in Young Children With Acute Wheezing: A Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/41729513/