Route of Delivery of Beta-Agonist Therapy
Max Rubinstein
Benjamin A. Nelson
Randomized Trial of Salbutamol via Metered-Dose Inhaler With Spacer Versus Nebulizer for Acute Wheezing in Children Less Than 2 Years of Age
Rubilar L, Castro-Rodriguez JA, Girardi G. Pediatr Pulmonol. 2000;29(4):264–269
Background
Metered-dose inhalers (MDI) with spacers deliver more medication directly to the lungs, and offer ease of use, portability, and cost effectiveness. However, in young children requiring treatment for wheezing, nebulized route of administration was utilized near universally.1 Studies in older patients suggested equivalency of beta-2 (β2) agonist administered via MDI vs. nebulizers (NEB); data were limited in young children.
Objectives
To compare the efficacy of β2-agonist (salbutamol) administration via NEB vs. MDI with spacer in children <2 years of age.
Methods
Single-blind, randomized clinical trial in a pediatric emergency department (ED) in Chile during a single winter.
Patients
123 children ages 1 to 24 months presenting with moderate-to-severe wheezing characterized by a standardized score. Select exclusion criteria: pneumonia; chronic pulmonary, cardiac, or neurologic disease; foreign body aspiration.
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