EFFICACY OF SALBUTAMOL DELIVERED THROUGH A METERED DOSE INHALER & SPACER IN CHILDREN WITH ACUTE EXACERBATION OF ASTHMA

Abstract

Objective: To assess efficacy of salbutamol delivered through metered dose inhaler (MDI) - spacer in paediatric patients with acute exacerbation of asthma.
 Study Design: Prospective observational study.
 Place and Duration of Study: Department of Paediatrics, Pakistan Naval Ship, Shifa Hospital, Karachi-Pakistan, from Jan to Dec 2018.
 Methodology: Ninety Five patients aged ≥6 to ≤12 years, with acute asthma exacerbation were enrolled. Any patient with fever, clinical asthma score (CAS) >7, on home treatment with drugs delivered through nebulization or on oral steroids was excluded. Clinical asthma score recorded on presentation, followed with salbutamol via Metered Dose Inhaler & spacer at dose of 400 µgm (4 x puffs of 100 µgm). Clinical asthma score rechecked after 20 min. Response to salbutamol was then compared in relation to the presenting Clinical asthma score.
 Results: Out of 95 children, 45 (47.9%) were male & 50 (52.1%) female with 67.4% having positive family history for asthma. Average premedication clinical asthma score was 2.44. Sixty nine (72.9%) patients had an adequate response as they exhibited clinical asthma score of 0 or fall in score of ≥2. Patients with adequate response had average clinical asthma score of 2.07 on presentation in contrast to 3.42 with inadequate response.
 Conclusion: Salbutamol delivered via Metered Dose Inhaler & spacer at dose of 400 µgm is an effective medication for quick relief in children with acute exacerbation of asthma. Moreover, its administration at a point where exacerbation is not much severe steers us towards more favourable outcome.

Spacers versus Nebulizers in Treatment of Acute Asthma A Prospective Randomized Study in Preschool Children

“…Asthma affects approximately 14 million adult Americans and is responsible for over 450,000 hospitalizations each year. Every year, approximately 1.8 million asthma patients visit the emergency department (1). Exacerbations of pediatric asthma place a huge medical and financial strain on healthcare systems as well as society at large.…”

“…Because it delivers drugs directly to the target organ, inhaled bronchodilator therapy is the first and most important treatment for asthma exacerbations. Even after multiple doses or continuous treatment, lower doses can be used to achieve comparable efficacy while reducing side effects (1) . Albuterol, the most commonly used bronchodilator, was previously administered via nebulization (NEB) with compressed air/oxygen.…”