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
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This research was supported by the University of Cincinnati.
Dr. Newman is currently an employee of Forest Laboratories.