A Cochrane review found no difference between commercial and home-made spacers in delivering bronchodilator: http://goo.gl/c7lVf
Home-made spacers for bronchodilator therapy in children with acute asthma were as effective as commercial spacers in a RCT published in the Lancet. A conventional spacer and sealed 500 mL plastic bottle produced similar bronchodilation in children with acute asthma: http://bit.ly/VOXkj
Recently, I saw a blog post titled "Treating Asthma on the Cheap" which described a spacer device made out of a 500-ml water bottle. It sounds unlikely but this may work after all.
Commercial versus home-made spacers in delivering bronchodilator therapy for acute therapy in children | Cochrane Summaries, 2011.
What is the best spacer? AeroChamber, toilet paper roll (?!), paper towel roll, rolled paper, plastic bottle spacer, bottle-holding chamber, nebulizer reservoir tubing? Paper towel roll was the best in this study: http://buff.ly/1jtRHCp
A recent letter claims that spacers should not be regarded as interchangeable: each pMDI–spacer combination should be treated as a unique system (ERJ, 2012).
Image source: Plastic bottles before processing. Wikipedia, dierk schaefer, Creative Commons Attribution 2.0 License.
Comments from Twitter:
Natasha Burgert @DoctorNatasha: Really? Hmmmm. RT @DrVes: Home-made spacers as effective as commercial spacers for bronchodilator therapy in children goo.gl/bKt17
Michelle Haley, MD @HaleyDoc: Wow! I learned to make one in residency from a plastic gallon milk jug- who knew!!