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Treatment of acute asthma: Salbutamol via jet nebuliser vs spacer and metered dose inhaler
Author(s) -
ROBERTSON CF,
NORDEN MA,
FITZGERALD DA,
CONNOR FL,
VAN ASPEREN PP,
COOPER PJ,
FRANCIS PW,
ALLEN HDW
Publication year - 1998
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1046/j.1440-1754.1998.00184.x
Subject(s) - salbutamol , medicine , metered dose inhaler , inhaler , asthma , anesthesia , bronchodilator , emergency department , psychiatry
Objective: To compare the efficacy of salbutamol delivered by jet nebuliser (JN) with salbutamol via a pressurised metered dose inhaler (PMDI) and a large volume spacer (Volumatic) for management of acute asthma. Study population: A total of 160 children aged from 4 to 12 years presenting to an Emergency Department with acute asthma. Methods: The study was of multicentre ( n =5) randomised, double blind, parallel design. Children weighing less than 25 kg received salbutamol 2.5 mg via the JN or 600 μ g (six puffs) from the PMDI. Children over 25 kg received salbutamol 5 mg via the JN or 1200 μ g (12 puffs) via the PMDI. Clinical score (range 0–12) and PEF (over 7 years) were recorded at baseline and 15, 30, 45 and 60 mins post administration. Results: The improvement from baseline at 30 min in the clinical score was 1.87 for JN and 1.43 for PMDI ( P =0.09) and at 60 min was 2.15 for JN and 1.12 for PMDI ( P =0.0001). The improvement in PEF at 30 min was 51 L min −1 for JN and 27 L min −1 for PMDI ( P =0.0007) and at 60 min was 57 L min −1 for JN and 31.5 L min −1 for PMDI ( P =0.001). Conclusion: Administration of salbutamol via a PMDI and a large volume spacer device provides effective relief in the management of acute asthma in children, but to a lesser extent than a jet nebuliser. This difference may represent a dose response effect.