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Efficacy of metered-dose inhalers for children with acute asthma exacerbations

Anne Eng Neo Goh1, Jenny Poh Lin Tang, Ho Ling

  • 1KK Women's and Children's Hospital, Singapore, Singapore. anne.goh.en@kkh.com.sg.

Pediatric Pulmonology
|January 4, 2011
PubMed

Insights

Using a metered-dose inhaler (MDI) with spacers proved effective for managing childhood asthma exacerbations in the emergency room and during inpatient care. This approach reduced readmission rates and healthcare costs, demonstrating its clinical and economic benefits.

Area of Science:

  • Pediatric Emergency Medicine
  • Respiratory Medicine
  • Clinical Pharmacy

Background:

  • Acute asthma exacerbations in children present a significant healthcare burden.
  • Current management often relies on nebulized bronchodilators.
  • Evidence-based pathways are crucial for optimizing acute asthma care.

Purpose of the Study:

  • To compare the effectiveness of inhaled beta-agonists via metered-dose inhaler (MDI) with spacers versus nebulization for acute pediatric asthma exacerbations.
  • To evaluate the impact of an evidence-based asthma pathway utilizing MDIs on patient outcomes and resource utilization.

Main Methods:

  • A case-control study with historical controls was conducted at KK Women's and Children's Hospital.
  • Included 19,951 children (infants to 18 years) presenting to the emergency room with asthma exacerbations.
  • Compared outcomes before and after implementing an MDI-based asthma pathway.

Main Results:

  • No increase in hospital admission rates or intensive/high dependency care admissions was observed with MDI use.
  • A significant reduction in 72-hour re-attendance rates was noted (mean difference 1.4%).
  • Average length of stay and cost per patient for inpatient asthma exacerbations were reduced.

Conclusions:

  • The implementation of an evidence-based asthma pathway using MDIs with spacers is effective for managing acute pediatric asthma exacerbations.
  • This approach improves patient outcomes, reduces readmissions, and lowers healthcare costs.
  • MDIs with spacers offer a viable and efficient alternative to nebulization in pediatric asthma management.
Abstract

Keywords:
acute asthmaasthma pathwayefficacymetered-dose inhalersnebulizers

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