EFFICACY OF ALBUTEROL ADMINISTERED BY NEBULIZER VERSUS SPACER DEVICE IN CHILDREN WITH ACUTE ASTHMA

The aim of this study was to compare the response to inhaled albuterol after administration by nebulizer with the response after administrat ion by a metered-dose inhaler and spacer device (MDI-spacer) to childr en with acute asthma. In a double-blind fashion, 33 children (6 to 14 years of age) with forced expiratory volume in 1 second (FEV1) between 20% and 70% of predicted values, and who were seen in the emergency d epartment with acute asthma, were studied. They were treated with aero solized albuterol or placebo by MDI-spacer, followed immediately by al buterol or placebo administered by nebulizer with oxygen. The dose rat io for albuterol by MDI-spacer versus nebulizer was 1:5. Outcome measu res included a clinical score, respiratory rate, arterial oxygen satur ation, and FEV1, measured before and 10, 20, and 40 minutes after trea tment. With the exception of heart rate (which increased in the nebuli zer group and decreased in the MDI-spacer group (p <0.05)), no differe nce in the rate of improvement of clinical score, respiratory rate, ar terial oxygen saturation, or FEV1 was noted during the 40-minute study period between children who received albuterol by nebulizer and those who received it by MDI-spacer. We conclude that spacers and nebulizer s are equally effective means of delivering beta2-agonists to children with acute asthma.