Comparison of salbutamol efficacy in children- via themetered-dose inhaler (MDI) with Volumatic® spacerand via the dry powder inhaler, Easyhaler®, with thenebulizer - in mild to moderate asthma exacerbation: A multicenter, randomized study

• Main Authors: Direkwatanachai C., Teeratakulpisarn J., Suntornlohanakul S., Trakultivakorn M., Ngamphaiboon J., Wongpitoon N., Vangveeravong M.
• Format: Article
• Language: English
• Published: 2014
• Online Access: http://www.scopus.com/inward/record.url?eid=2-s2.0-79958266250&partnerID=40&md5=3223c46d71082da22f8d1c2d53910264; http://cmuir.cmu.ac.th/handle/6653943832/3776
• Institution: Chiang Mai University

Background: β2 agonist administered via anebulizer is the standard treatment for acuteasthma exacerbation. There are somelimitations for the use of nebulization. Weconducted a study to determine the efficacy ofsalbutamol administered via the pMDI withVolumatic® spacer and the Easyhaler®(DPI)compared to nebulization in mild to moderateasthma exacerbations in children.Methods: A multicenter, randomized,controlled study was conducted in childrenbetween 5 and 18 years of age who presented atan emergency or outpatient department. Theywere randomized to receive either 6 puffs ofsalbutamol via the pMDI with Volumatic® spacer, or via the Easyhaler®, or 0.15 mg/kg ofsalbutamol nebulized via oxygen (orcompressed air). The primary outcome was theclinical response which was assessed using themodified Wood's asthma score. The secondaryoutcomes were: hospitalization, asthma revisitwithin 3 days, systemic corticosteroid useand adverse events. The clinical score, oxygensaturation, PR, RR, BP and adverse eventswere recorded at time 0 (before treatment) and 20, 40 and 60 minutes after drugadministration.Results: There were no statistically significantdifferences in the clinical response between thethree groups at the 1st, 2nd or 3rd dose or for theSpO2 or the respiratory rate while the childrenin the Easyhaler® group had significantly lesstachycardia after the 2nd dose. No significantadverse events were noted among the threegroups.Conclusions: Salbutamol administered via pMDIwith Volumatic® spacer or DPI (Easyhaler®) areas effective as salbutamol given via a nebulizerin providing effective relief of mild to moderateseverity acute asthma exacerbation in childrenbetween 5 and 18 years of age.