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

Abstract

Background: 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. Aerosol delivery to mechanically ventilated patients utilizing nebulizers or metered dose inhalers (MDI) with spacers has been shown to be feasible and beneficial. Aim and Objectives: The goal of this study was to analyse MDI aerosol administration with spacer delivery and nebulizer among preschool kids. Material and Methods: A randomized, double-blind medical experiment involving 200 preschool children were divided into 2 groups received active drug either by nebulizer (group 1=100 patients) or MDI-spacer (group 2=100 patients). Assessment was done including clinical history, medications history, height, weight and BMI. All of the following parameters were measured: heart rate, respiratory rate, and arterial oxygen saturation while the children were awake and breathing room air. FEV1 was calculated using a portable spirometer. These clinical and laboratory tests were performed 10, 20, and 40 minutes after using the nebulizer. Results: The mean age in months was 25.4 ± 12.7 among group 1 and 26.6 ± 11.6 among group 2. Group 1 included 43% males and 57% females while group 2 included 52% males and 48% females. The mean BMI for age z score in group 1 was 0.31 & 0.97 and 0.32 & 0.89 in group 2. There was a statistically substantial variation between the two groups in terms of FEV1. In terms of heart rate, respiratory rate oxygen saturation, or hospital stay duration, there was no statistically substantial variation between the two groups. Conclusion:The MDI-spacer and the nebulizer both delivered salbutamol equally well aerosol therapy to preschool children suffering from wheezes and acute asthma exacerbations. The spacer had higher effect on FEV1 than nebulizer but there was no difference regarding oxygen saturation and hospital stay duration.