Abstract
Objective: To determine if administration of albuterol by a metered-dose inhaler with a spacer device is as efficacious as administration of albuterol by nebulizer to treat wheezing in children aged 2 years and younger. Design: Double-blind, randomized, placebo-controlled clinical trial. Setting: Pediatric emergency department. Patients: From a convenience sample of wheezing children aged 2 to 24 months, 85 patients were enrolled in the nebulizer group and 83 in the spacer group. Interventions: The nebulizer group received a placebo metered-dose inhaler with a spacer followed by nebulized albuterol. The spacer group received albuterol by a metered-dose inhaler with a spacer followed by nebulized isotonic sodium chloride solution. Treatments were given every 20 minutes by a single investigator blinded to group assignment. Main Outcome Measures: The primary outcome was admission rate. Pulmonary Index score and oxygen saturation were measured initially and 10 minutes after each treatment. Results: The nebulizer group had a significantly higher mean (SD) initial Pulmonary Index score compared with the spacer group (7.6 [2.5] vs 6.6 [2.0]; P=.002). With the initial Pulmonary Index score controlled, children in the spacer group were admitted less (5% vs 20%; P=.05). Analyses also revealed an interaction between group and initial Pulmonary Index score; lower admission rates in the spacer group were found primarily in children having a more severe asthma exacerbation. Conclusion: Our data suggest that metered-dose inhalers with spacers may be as efficacious as nebulizers for the emergency department treatment of wheezing in children aged 2 years or younger.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 76-80 |
| Number of pages | 5 |
| Journal | Archives of Pediatrics and Adolescent Medicine |
| Volume | 157 |
| Issue number | 1 |
| State | Published - Jan 1 2003 |
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ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
Cite this
Nebulizers vs metered-dose inhalers with spacers for bronchodilator therapy to treat wheezing in children aged 2 to 24 months in a pediatric emergency department. / Delgado, Annette; Chou, Katherine J.; Silver, Ellen J.; Crain, Ellen F.
In: Archives of Pediatrics and Adolescent Medicine, Vol. 157, No. 1, 01.01.2003, p. 76-80.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Nebulizers vs metered-dose inhalers with spacers for bronchodilator therapy to treat wheezing in children aged 2 to 24 months in a pediatric emergency department
AU - Delgado, Annette
AU - Chou, Katherine J.
AU - Silver, Ellen J.
AU - Crain, Ellen F.
PY - 2003/1/1
Y1 - 2003/1/1
N2 - Objective: To determine if administration of albuterol by a metered-dose inhaler with a spacer device is as efficacious as administration of albuterol by nebulizer to treat wheezing in children aged 2 years and younger. Design: Double-blind, randomized, placebo-controlled clinical trial. Setting: Pediatric emergency department. Patients: From a convenience sample of wheezing children aged 2 to 24 months, 85 patients were enrolled in the nebulizer group and 83 in the spacer group. Interventions: The nebulizer group received a placebo metered-dose inhaler with a spacer followed by nebulized albuterol. The spacer group received albuterol by a metered-dose inhaler with a spacer followed by nebulized isotonic sodium chloride solution. Treatments were given every 20 minutes by a single investigator blinded to group assignment. Main Outcome Measures: The primary outcome was admission rate. Pulmonary Index score and oxygen saturation were measured initially and 10 minutes after each treatment. Results: The nebulizer group had a significantly higher mean (SD) initial Pulmonary Index score compared with the spacer group (7.6 [2.5] vs 6.6 [2.0]; P=.002). With the initial Pulmonary Index score controlled, children in the spacer group were admitted less (5% vs 20%; P=.05). Analyses also revealed an interaction between group and initial Pulmonary Index score; lower admission rates in the spacer group were found primarily in children having a more severe asthma exacerbation. Conclusion: Our data suggest that metered-dose inhalers with spacers may be as efficacious as nebulizers for the emergency department treatment of wheezing in children aged 2 years or younger.
AB - Objective: To determine if administration of albuterol by a metered-dose inhaler with a spacer device is as efficacious as administration of albuterol by nebulizer to treat wheezing in children aged 2 years and younger. Design: Double-blind, randomized, placebo-controlled clinical trial. Setting: Pediatric emergency department. Patients: From a convenience sample of wheezing children aged 2 to 24 months, 85 patients were enrolled in the nebulizer group and 83 in the spacer group. Interventions: The nebulizer group received a placebo metered-dose inhaler with a spacer followed by nebulized albuterol. The spacer group received albuterol by a metered-dose inhaler with a spacer followed by nebulized isotonic sodium chloride solution. Treatments were given every 20 minutes by a single investigator blinded to group assignment. Main Outcome Measures: The primary outcome was admission rate. Pulmonary Index score and oxygen saturation were measured initially and 10 minutes after each treatment. Results: The nebulizer group had a significantly higher mean (SD) initial Pulmonary Index score compared with the spacer group (7.6 [2.5] vs 6.6 [2.0]; P=.002). With the initial Pulmonary Index score controlled, children in the spacer group were admitted less (5% vs 20%; P=.05). Analyses also revealed an interaction between group and initial Pulmonary Index score; lower admission rates in the spacer group were found primarily in children having a more severe asthma exacerbation. Conclusion: Our data suggest that metered-dose inhalers with spacers may be as efficacious as nebulizers for the emergency department treatment of wheezing in children aged 2 years or younger.
UR - http://www.scopus.com/inward/record.url?scp=0037235719&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0037235719&partnerID=8YFLogxK
M3 - Article
C2 - 12517199
AN - SCOPUS:0037235719
VL - 157
SP - 76
EP - 80
JO - JAMA Pediatrics
JF - JAMA Pediatrics
SN - 2168-6203
IS - 1
ER -