• J Pak Med Assoc · Dec 2006

    Randomized Controlled Trial Comparative Study

    Management of acute asthma in children using metered dose inhaler and small volume nebulizer.

    • Syed Waseem Jamalvi, Syed Jamal Raza, Farah Naz, Samina Shamim, and S M Zia-ul-Wahab Jamalvi.
    • Department of Pediatrics, Jinnah Medical and Dental College, Karachi.
    • J Pak Med Assoc. 2006 Dec 1;56(12):595-9.

    ObjectiveTo determine whether the administration of beta2-agonist by Metered Dose inhaler (MDI) with accessory device (AD) is a as effective as the administration of beta2-agonist by small volume nebulizers (SVN) for the treatment of acute asthma.MethodsA cross sectional study was conducted at Emergency Room (ER) of National Institute of Child Health (NICH), Karachi, between October 2000 to March 2001. This study included 150 children, 6 months and older with a history of wheeze and presenting with an acute asthma exacerbation. Children were categorized into mild, moderate and severe asthma according to medical scoring system. Children were assigned randomly into group A and B to receive standard dose of beta2-agonist (salbutamol) by MDI/AD (group A) or SVN (group B). Baseline characteristics and asthma severity were recorded. All variables (dyspnoea, use of accessory muscles, cyanosis, respiratory rate, heart rate, blood pressure, oxygen saturation, pulsus paradoxus, and wheeze) and Peak Expiratory Flow Rate (PEFR) in children 5 years and older, were determined at pre and post inhalation therapy.ResultsBoth groups did not differ in demographic characteristics. There were no significant differences in outcome measures. In children treated with MDI/ADs and SVNs. PEFR increased significantly in both the groups after completion of treatment, but PEFR was not statistically significant when compared in between groups.ConclusionThe data suggested that MDI/AD is an effective alternative to nebulizer for the treatment of children with acute asthma exacerbation in the ER.

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