title: Experience with a metered-dose inhaler with a spacer in the pediatric emergency department.
abstract: Studies of adults suggest that metered-dose inhalers with spacers are as effective as hand-held nebulizers for bronchodilator delivery. We studied 13 children with acute asthma. They received two puffs every 2 minutes from metered-dose inhalers with spacers (range, 4 to 14 puffs) titrated until improvement stopped. Peak expiratory flow increased 34% for metered-dose inhalers with spacers after the first 2 puffs and increased 87% for metered-dose inhalers with spacers after dose titration. After titration, respiratory rate decreased by 12%, heart rate increased by 2%, and breath sounds improved in 92% of the patients. We concluded that the metered-dose inhalers with spacers are an effective device for the treatment of asthma in the pediatric emergency department and that the use of metered-dose inhalers with spacers with titration can achieve significant bronchodilation in the treatment of patients with acute asthma.
authors.affiliation: Childrens Hospital Medical Center, Oakland, CA 94609.
authors.forename: G
authors.initials: G
authors.lastname: Benton
authors.forename: R C
authors.initials: RC
authors.lastname: Thomas
authors.forename: B G
authors.initials: BG
authors.lastname: Nickerson
authors.forename: J C
authors.initials: JC
authors.lastname: McQuitty
authors.forename: J
authors.initials: J
authors.lastname: Okikawa
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000420:Albuterol / Q000008:administration & dosage / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D009330:Nebulizers and Vaporizers; D010100:Oxygen / Q000008:administration & dosage; D010366:Peak Expiratory Flow Rate / Q000379:methods
chemical_list: D000420:Albuterol; D010100:Oxygen