Comparison of Salbutamol Delivered Via Jet Nebulizer With A Metered Dose Inhaler (MDI) Plus A Spacer for Asthma Exacerbation of Children: A Randomized Clinical Trial

Abstract

Asthma is the most common chronic illness in children and is a major reason for pediatric emergency department visits. Beta-2 agonists are considered the most effective drugs for immediate relief in the symptoms. This study aimed to compare the effectiveness of salbutamol delivered via jet nebulizer with a metered-dose inhaler (MDI) plus a spacer for asthma exacerbation in the pediatric emergency departments. The study was a randomized control, parallel-group design in children with age ranging from 6 months to 14 years, presenting in the emergency department with an acute asthma attack. A total of 116 patients were recruited for the study. Sixty-two patients were enrolled in the MDI/spacer group, and 54 patients were in the nebulizer group. Patients were assessed at baseline (0 min) and 15, 30, 45 and 60 min after commencement of the nebulizer and MDI/spacer. The response of each group to treatment was compared. The parents were counseled for their child enrolment in the study, which was approved by the Human Ethics Committee of Shahid Beheshti University of Medical Sciences. Ethic code was IR.SBMU.SM.REC.1394.19. The patients in both treatment groups demonstrated statistically noticeable improvement in clinical scores at all study assessment periods. Results revealed that salbutamol via MDI/spacer was as effective as salbutamol nebulization during the treatment of asthma exacerbations. Salbutamol MDI/spacer is equally efficacious when compared to nebulization. Therefore, because Salbutamol MDI/spacer is more user-friendly and affordable, it is preferable to be used in emergency departments.