Pear shaped spacer nebuhaler compared with nebulised solution for terbutaline administration in acute severe asthma

The efficacy of terbutaline (1 mg) administered from pressurised aerosol through a nebuhaler was compared in a crossover trial with terbutaline (4 mg) as nebulised solution in 20 patients with acute severe asthma. The improvements following the nebuhaler, which did not require an electrical or pressure source, were worthwhile. In contrast to earlier experience in stable asthma, the increases in FEV1 (p = 0.04) and VC (p = 0.05) at 20 minutes were greater following the higher dose as nebuliser solution than following nebuhaler use. Nebuhaler technique requires individual attention since some patients with the severe asthma breathed out through the nebuhaler reservoir due to failure to close the one-way valve.