Optimal Duration of Nebulized Albuterol Therapy

Malone, Randolph A.; Hollie, Michael C.; Glynn-Barnhart, Anne M.; Nelson, Harold S.

doi:10.1378/chest.104.4.1114

Cited by 35 publications

(11 citation statements)

References 14 publications

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“…27 In a study with 359 children, ages 6 months to 8 years, with mild persistent asthma, Virant found that aerosol delivery was equally effective via mask or mouthpiece, 28 and studies by Malone et al, 29 Mellon et al, 30 and Lowenthal and Kattan 31 support that finding. Mask design and face seal (fit) may play a large role in lung deposition.…”

Section: Discussionmentioning

confidence: 96%

Randomized Controlled Trial of a Breath-Actuated Nebulizer in Pediatric Asthma Patients in the Emergency Department

Sabato¹,

Ward²,

Hawk³

et al. 2011

Respir Care

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BACKGROUND: Bronchodilator treatment for asthma can be provided with various aerosolgenerating devices and methods. There have been no randomized trials of a breath-actuated nebulizer versus continuous 1-hour nebulization and/or small-volume constant-output nebulizer in pediatric asthma patients. METHODS: We conducted a randomized study of one-time albuterol treatment with the AeroEclipse breath-actuated nebulizer versus standard therapy (single treatment via small-volume nebulizer or 1-hour of continuous nebulized albuterol) in pediatric asthma patients in the emergency department. Eligible patients were those admitted to the emergency department, 0 months to 18 years of age, who presented with asthma or wheezing. We assessed all the patients with our clinical asthma scoring system and peak-flow measurement if possible. We stratified the patients by clinical asthma score and weight, and then randomized them to receive their initial albuterol treatment in the emergency department via either AeroEclipse or standard therapy. We recorded time in the emergency department, change in clinical asthma score, need for additional bronchodilator treatments, need for admission, patient response, ability to actuate the AeroEclipse, and adverse effects. RESULTS: We enrolled 149 patients between October 14, 2004 and November 11, 2005, and we randomized 84 patients to AeroEclipse and 65 to standard therapy. The cohort's average age was 5.5 years. There were no significant differences in demographics. The initial mean clinical asthma scores were 5.1 ؎ 2.4 in the AeroEclipse group, and 5.1 ؎ 2.1 in the standard-therapy group. Time in the emergency department was not different (AeroEclipse 102 min, standard therapy 125 min, P ‫؍‬ .10), but the AeroEclipse group had a significantly greater improvement in clinical asthma score (1.9 ؎ 1.2 vs 1.2 ؎ 1.4, P ‫؍‬ .001) and respiratory rate (P ‫؍‬ .002), and significantly lower admission rate (38% vs 57%, P ‫؍‬ .03). There was no difference in adverse effects. CONCLUSIONS: Although AeroEclipse did not reduce the time in the ED, it significantly improved clinical asthma score, decreased admissions, and decreased respiratory rate.

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Section: Discussionmentioning

confidence: 96%

Randomized Controlled Trial of a Breath-Actuated Nebulizer in Pediatric Asthma Patients in the Emergency Department

Sabato¹,

Ward²,

Hawk³

et al. 2011

Respir Care

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“…Understandably, such an objective is complicated by the many and often interrelated factors that affect nebulizer performance, not least the physicochemical properties of the drug and that of the associated excipient to be administered [67,68], dose, fill volume and concentration [26,[69][70][71], respiratory flow rate [72,73], measurement method (in vitro or in vivo) [26,74], in vitro aerosol collection and measurement method [70,75,76], ambient conditions (e.g., relative humidity) [77] and environmental context (hospital or point-of-care; availability of trained respiratory therapists to administer treatment) [21,78], as well as patient-related factors such as breathing mode (nasal or oral) and pattern (tidal or deep breathing; breath-holding) [67,[79][80][81], severity of illness [21], age group [35,[82][83][84], and physiological profile (e.g., lung morphology) [26,85,86]. Other patient factors such as gender and ethnicity as well as environmental and occupational exposure [87], both past and present, could also be important, although their effects have yet to be studied extensively.…”

Section: Performance Comparison Between Nebulizersmentioning

confidence: 99%

Ultrasonic nebulization platforms for pulmonary drug delivery

Yeo¹,

Friend²,

McIntosh³

et al. 2010

Expert Opinion on Drug Delivery

110

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Recent advances in ultrasonic nebulization technology demonstrate significant potential for the development of smart, portable inhalation therapy platforms for the future. Nevertheless, there remain considerable challenges that need to be addressed before such personalized delivery systems can be realized. These have to be addressed across the spectrum from fundamental physics through to in vivo device testing and dealing with the relevant regulatory framework.

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“…1 In fact, research has suggested that after the onset of sputter very little additional drug is inhaled. 1,25 As patient adherence to therapy is a critical component to out-patient main- tenance therapy, many clinicians recommend discontinuing treatment either at or 1 min after sputter onset. The final area of clinical concern revolves around the patient-device interface, which occurs mainly in the pediatric and in-patient settings.…”

Section: Other Nuances and Characteristics Of Svnsmentioning

confidence: 99%

The Science Guiding Selection of an Aerosol Delivery Device

Myers

2013

Respir Care

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Aerosol therapy continues to be considered as one of the cornerstones of the profession of respiratory care, even after 60 years. Aerosol therapy serves as a critical intervention for both exacerbations and chronic maintenance for a variety of respiratory care conditions. Aerosol therapy uniquely blends both the art and science of medicine together to produce the practical and necessary clinical outcomes for patients with respiratory diseases. This review was presented as part of the New Horizons Symposium on how to guide the scientific selection of an appropriate aerosol device.

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Optimal Duration of Nebulized Albuterol Therapy

Cited by 35 publications

References 14 publications

Randomized Controlled Trial of a Breath-Actuated Nebulizer in Pediatric Asthma Patients in the Emergency Department

Randomized Controlled Trial of a Breath-Actuated Nebulizer in Pediatric Asthma Patients in the Emergency Department

Ultrasonic nebulization platforms for pulmonary drug delivery

The Science Guiding Selection of an Aerosol Delivery Device

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