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Clinical Investigations: AsthmaContinuous vs Intermittent Albuterol, at High and Low Doses, in the Treatment of Severe Acute Asthma in Adults
Section snippets
MATERIALS AND METHODS
The study was approved by the Institutional Review Board of the University of Texas Southwestern Medical Center. Patients were recruited from the ED of Parkland Memorial Hospital by the treating physician if they met the following entry criteria: (1) a diagnosis of acute asthma;6 (2) an initial FEV1 of less than 40% of predicted; (3) development of asthma at an age younger than 45 years; (4) at least 18 years of age, not pregnant or breast feeding, and not incarcerated; (5) no history of
RESULTS
The four groups were similar in terms of demographics, vital signs, and severity of disease (Table 1).
Figure 1 shows the progression of FEV1 values for the four groups with treatment. The changes in FEV1 and percent predicted FEV1 with treatment are shown in Table 2. After the first hour of nebulization therapy, the improvement in FEV1 was greatest for the two continuously treated groups. The improvement seen in these two groups was indistinguishable. The standard-dose intermittent treatment
DISCUSSION
High-dose (7.5 mg) albuterol delivered continuously over each hour is similar to the National Heart Lung and Blood Institute Expert Panel's recommended initial treatment of acute asthma of three 2.5-mg nebulization treatments over the course of 1 or 1.5 h.1 Surprisingly, the effect of this treatment was matched by the improvement in FEV1 seen with the standard-dose (2.5 mg) albuterol treatment diluted to last an hour. Both continuously treated groups improved their FEV1 values by approximately
ACKNOWLEDGMENTS
The authors would like to thank Thomas Carmody, PhD, Academic Computing Center, University of Texas Southwestern Medical Center, for assistance with, statistical analysis; Parkland Memorial Hospital, where the research was conducted; and all the patient participants, without whom any research would have been impossible.
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