A low dose of albuterol (salbutamol) by metered dose inhaler (MDI) with a spacer was as effective as higher doses by MDI or low doses by nebuliser in children with mild acute asthma
QUESTION: In children with mild acute asthma, is albuterol (salbutamol) delivered by a metered dose inhaler (MDI) with a spacer (standard low dose or higher, weight adjusted dose) as effective as albuterol delivered by a nebuliser?
Randomised (concealed), blinded (patient and outcome assessor), controlled trial.
A hospital emergency department in Toronto, Ontario, Canada.
90 children who were 5–17 years of age (mean 9.2 y, mean baseline forced expiratory volume in 1 second [FEV1] 62.8%) who presented with acute asthma exacerbation between 0800 and 2200, could reliably perform pulmonary function testing, and had a baseline FEV1 of 50%–79% of the predicted value. Children were excluded if this was their first wheezing episode, they had used albuterol within 4 hours of the visit, had concurrent cardiopulmonary disease, or had hypersensitivity to albuterol.
30 children were allocated to a standard low dose of albuterol by MDI with a clear plastic 140 ml spacer device with a mouthpiece …