Chest
Clinical InvestigationsASTHMAA Comparison of Albuterol Administered by Metered-Dose Inhaler and Spacer With Albuterol by Nebulizer in Adults Presenting to an Urban Emergency Department With Acute Asthma
Section snippets
Patients
Patients who were admitted to the study were consecutive adult patients who were > 18 years of age and had presented to the ED of the University of Cincinnati Medical Center from October 1994 to April 1997 with an acute exacerbation of asthma. All patients with acute asthma who were seen by physicians in the ED during this period were included in the study. A total of 2,342 ED visits for acute asthma were recorded and statistically evaluated. Smoking was not an exclusion criterion in this study.
Results
The majority of patients participating in the study were African-American (75.4%). Most were women (58.6%), and the mean (± SD) age of participants was 35.5 ± 13.5 years. Data entries were gathered and compiled from a total of 2,342 ED visits. The total number of unique patients seen at these visits was 1,429. There were no significant differences in demographic characteristics between patients in phase 1 (nebulizer) and those in phase 2 (MDI/spacer) [Table 1].
Medication use at the time of
Discussion
This large study of 2,342 consecutive ED visits for acute asthma demonstrated that the delivery of albuterol by MDI/spacer was as effective as delivering albuterol by nebulizer. There was statistically greater improvement (13.3%) in PEFR values in the MDI/spacer group than in the nebulizer group. However, this did not result in a statistically significantly lower hospital admission rate, with 13.2% of patients in the MDI group and 14.6% of patients in the nebulizer group being admitted to the
References (23)
- et al.
Continuous versus intermittent albuterol nebulization in the treatment of acute asthma
Ann Emerg Med
(1993) - et al.
Comparison of intermittent and continuously nebulized albuterol for treatment of asthma in an urban emergency department
Ann Emerg Med
(1993) - et al.
Emergency department treatment of severe asthma: metered-dose inhaler plus holding chamber is equivalent in effectiveness to nebulizer
Chest
(1993) - et al.
A comparison of albuterol administered by metered dose inhaler (and holding chamber) or wet nebulizer in acute asthma
Chest
(1993) - et al.
Efficacy of albuterol administered by nebulizer versus spacer device in children with acute asthma
J Pediatr
(1993) - et al.
Salbutamol treatment of acute severe asthma in the ED: MDI versus hand-held nebulizer
Am J Emerg Med
(1998) - et al.
Treatment of acute severe asthma with inhaled albuterol delivered via jet nebulizer, metered dose inhaler with spacer, or dry powder
Chest
(1997) - et al.
Comparison of albuterol delivered by a metered dose inhaler with spacer versus a nebulizer in children with mild acute asthma
J Pediatr
(1999) - et al.
Salmeterol administration by metered-dose inhaler alone vs metered-dose inhaler plus valved holding chamber
Chest
(2000) - et al.
A model for conversion from small volume nebulizer to metered dose inhaler aerosol therapy
Chest
(1992)
Cited by (66)
GEMA 5.3. Spanish Guideline on the Management of Asthma
2023, Open Respiratory ArchivesAsthma in the Primary Care Setting
2019, Medical Clinics of North AmericaRandomized Clinical Trial Comparing Breath-Enhanced to Conventional Nebulizers in the Treatment of Children with Acute Asthma
2019, Journal of PediatricsCitation Excerpt :As such, conventional jet nebulizer was chosen as the control group for this study. We appreciate that MDIs have been demonstrated as noninferior to jet nebulizers,16,17,20,22-24 and that there are EDs that use MDI albuterol regularly. It is unclear from these results how breath-enhanced nebulizers compare with MDIs and further study would be needed to address this.
Updated guidelines (2015) for management and monitoring of adult and adolescent asthmatic patients (from 12 years and older) of the Société de Pneumologie de Langue Française (SPLF) (Full length text)
2016, Revue des Maladies RespiratoiresCitation Excerpt :The rescue therapy allows transiently improving symptoms the time for the cause of asthma symptom worsening to disappear or for the increase in controller treatment to be effective. Using a beta-2 agonist as a spray delivered into an inhalation chamber improves the lung function as with a nebulizer [39,40] [A] (10 puffs or 1 mg). The use of an inhalation chamber in this acute context justifies a regular maintenance of the equipment [39,41] [A] [B].
Asthma essentials
2013, African Journal of Emergency Medicine
This research was supported by the University of Cincinnati.
Dr. Newman is currently an employee of Forest Laboratories.