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Related Experiment Video

Updated: May 17, 2026

Dry Powder and Nebulized Aerosol Inhalation of Pharmaceuticals Delivered to Mice Using a Nose-only Exposure System

Dry Powder and Nebulized Aerosol Inhalation of Pharmaceuticals Delivered to Mice Using a Nose-only Exposure System

Published on: April 6, 2017

MDI versus Nebulizers for Acute Asthma.

Hengameh H Raissy¹, H William Kelly

¹Department of Pediatrics, The University of New Mexico, Health Sciences Center, Albuquerque, New Mexico.

The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG

|November 3, 2012

Summary

Metered dose inhalers with holding chambers and nebulizers show similar effectiveness for asthma exacerbations in the emergency department. Current trials lack power to prove differences in hospital admission rates for either treatment method.

Keywords:

asthma exacerbation emergency department metered dose inhaler nebulizer β2-agonists

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Area of Science:

Pulmonary Medicine
Emergency Medicine
Pharmacology

Background:

Asthma exacerbations are a common reason for emergency department visits.
Treatment typically involves inhaled bronchodilators, with nebulizers and metered dose inhalers (MDIs) with holding chambers being common delivery systems.

Purpose of the Study:

To compare the efficacy of metered dose inhalers with holding chambers versus nebulizers for treating asthma exacerbations in the emergency department.

Main Methods:

Systematic review of 21 randomized clinical trials from the Cochrane Airways Review Group and MEDLINE search (1966-2004).
Included studies compared clinical outcomes of beta-2 agonist administration via nebulizer or MDI with holding chamber.

Main Results:

No significant difference in hospital admission rates between MDI with holding chamber and nebulizer groups in children or adults.
Individual studies were underpowered to detect statistically significant differences in hospital admission rates.

Conclusions:

Available evidence suggests metered dose inhalers with holding chambers are equivalent to nebulizers for inhaled beta-2 agonist delivery in acute asthma.
Current trials may be biased against detecting differences; no clear clinical or economic advantage exists for either method in mild to moderate asthma.