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Randomized trial of salbutamol via metered‐dose inhaler with spacer versus nebulizer for acute wheezing in children less than 2 years of age
Author(s) -
Rubilar Lilian,
CastroRodriguez José A.,
Girardi Guido
Publication year - 2000
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/(sici)1099-0496(200004)29:4<264::aid-ppul5>3.0.co;2-s
Subject(s) - medicine , salbutamol , metered dose inhaler , nebulizer , inhaler , bronchodilator , randomized controlled trial , emergency department , confidence interval , odds ratio , anesthesia , betamethasone , clinical trial , population , asthma , pediatrics , environmental health , psychiatry
The aim of this study was to compare the efficacy of salbutamol delivered via a metered‐dose inhaler with a spacer and facial mask (MDI‐S) vs. a nebulizer (NEB) for the treatment of acute exacerbations of wheezing in children. In a single‐blind, prospective, randomized clinical trial, 123 outpatients (1–24 months of age), presenting with “moderate to severe” wheezing, were seen in the emergency department. Children were randomly assigned to one of two salbutamol treatment groups. In the first hour, the MDI‐S group received 2 puffs (100 μg/puff) every 10 min for 5 doses, and the NEB group received 0.25 mg/kg every 13 min for 3 doses. If the clinical score was >5 at the end of the first hour, the patients received another hour of the same treatment and also betamethasone (0.5 mg/kg intramuscular). On enrollment and after the first and the second hour of treatment each child had a validated clinical score assigned by a blinded investigator. There were no differences at the time of admission to the emergency department between groups in clinical score or demographic data. Success (clinical score ≤5) after the first hour of treatment was 90% (56/62) in the MDI‐S group and 71% (43/61) in the NEB group (odds ratio 3.9, 95% confidence interval 1.5–10.4, P = 0.01). After the second hour, the success was 100% in the MDI‐S and 94% in the NEB ( P > 0.05). We conclude that in this study population, children less than 2 years of age with moderate‐severe exacerbations of wheezing responded faster to salbutamol delivered by MDI with a spacer and facial mask than to salbutamol delivered by nebulizer. Pediatr Pulmonol. 2000;29:264–269. © 2000 Wiley‐Liss, Inc.