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COMPARISON OF TWO INHALATIONAL TECHNIQUES FOR BRONCHODILATOR ADMINISTRATION IN CHILDREN AND ADOLESCENTS WITH ACUTE

Cristian Roncada1,2, Julia Andrade1, Luísa Carolina Bischoff1

  • 1Centro Universitário da Serra Gaúcha, Caxias do Sul, RS, Brasil.

Revista Paulista De Pediatria : Orgao Oficial Da Sociedade De Pediatria De Sao Paulo
|July 12, 2018
PubMed

Insights

Nebulizers and metered-dose inhalers with spacers are equally effective for pediatric asthma rescue treatment. Both methods show no significant differences in improving heart rate, respiratory rate, oxygen saturation, or asthma scores in children.

Area of Science:

  • Pediatric Emergency Medicine
  • Respiratory Care
  • Clinical Pharmacology

Background:

  • Asthma is a common chronic respiratory disease in children, frequently requiring emergency treatment.
  • Bronchodilator delivery in pediatric emergency settings often involves nebulizers or metered-dose inhalers with spacers (MDI-spacer).
  • Evidence comparing the efficacy of these delivery methods for acute asthma exacerbations in children is crucial for clinical practice.

Purpose of the Study:

  • To compare the effectiveness of nebulizer versus MDI-spacer for delivering bronchodilators in pediatric asthma rescue treatment.
  • To evaluate cardiorespiratory parameters and asthma severity scores between the two inhalation techniques.
  • To inform best practices for asthma management in pediatric emergency units.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) was performed.
  • Searches were conducted across PubMed, SciELO, and ScienceDirect databases.
  • Nine RCTs comparing nebulization and MDI-spacer for pediatric asthma treatment in emergency settings were included.

Main Results:

  • No statistically significant differences were observed between nebulization and MDI-spacer for heart rate, respiratory rate, O2 saturation, or asthma scores.
  • The meta-analysis included nine studies, analyzing data from multiple pediatric emergency unit patients.
  • Specific confidence intervals for each outcome indicate a lack of meaningful clinical difference between the delivery methods.

Conclusions:

  • Both nebulizer and MDI-spacer are equally effective for delivering beta-2 agonists in pediatric asthma emergencies.
  • Clinicians can confidently utilize either method for acute asthma management in children based on availability and patient factors.
  • The findings support the use of MDI-spacers as a viable alternative to nebulizers in pediatric emergency care for asthma.
Abstract

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