Treatment
Delivery of a ß2 agonist by metered dose inhaler with a bottle spacer was equivalent to delivery by conventional spacer in young children with acute lower airway obstruction
Zar HJ, Streun S, Levin M, et al. Randomised controlled trial of the efficacy of a metered dose inhaler with bottle spacer for bronchodilator treatment in acute lower airway obstruction. Arch Dis Child 2007;92:142–6.
Q In young children with acute lower airway obstruction, is response to bronchodilator treatment given using a metered dose inhaler (MDI) with a bottle spacer equivalent to that given using a conventional spacer?
Key Words: bronchodilator agents • metered dose inhalers • inhalation spacers • asthma
| The first 150 words of the full text of this article appear below. |
Design:
randomised controlled equivalence trial.
Allocation:
concealed.
Blinding:
blinded ({healthcare providers, data collectors},* and clinical outcome assessors).
Follow up period:
after completion of 3 bronchodilator treatments.
Setting:
a children’s hospital in Cape Town, South Africa.
Patients:
400 children aged 2 months to 5 years (median age 12 mo, 39% boys) who presented with clinical signs of acute lower airway obstruction (expiratory wheeze on auscultation or hyperinflation of the chest) and had cough or difficulty breathing within the previous 5 days. Exclusion criteria were bronchodilator use in the previous 4 hours, underlying cardiac or chronic pulmonary disease (other than asthma), stridor, or daily oral corticosteroid treatment for >2 days before presentation.
Intervention:
salbutamol, 500 µg, 5 puffs given at 1 puff every 10 seconds from an MDI using a modified 500 ml plastic bottle spacer, where the end of the bottle was held in the mouth simulating a mouthpiece (n =
Laurentian University School of Nursing,
Sudbury, Ontario, Canada
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