title: Undiluted albuterol aerosols in the pediatric emergency department.
abstract: OBJECTIVE
  To evaluate the efficacy and efficiency of a short treatment method of administering albuterol aerosols.
  
  
  METHODS
  Fifty children 6 to 18 years of age with severe acute asthma (peak flow rates <60% of predicted) were enrolled in a single-blind, controlled trial in an urban pediatric emergency department. Patients were randomized to receive either the study short treatment (3.5 mL of undiluted albuterol nebulized for 20 inhalations) or the control treatment (albuterol diluted [.5 mL] and nebulized in normal saline [3 mL]) every 20 minutes for a total of 3 treatments. Peak flow and spirometric measurements were performed before and after each treatment.
  
  
  RESULTS
  There were 25 patients in the study group and 25 in the control group. There were no demographic differences between groups; both had comparable pulmonary function at presentation. The mean forced expiratory volume in 1 second percent predicted improvement between 0 and 60 minutes was 18.8% in the study group and 14.5% in the control group. The total time of treatment delivery for the study group was 6.4 minutes versus 32.7 minutes for the control group.
  
  
  CONCLUSIONS
  Undiluted albuterol short treatments seem to be as effective as standard diluted albuterol in severe asthmatics, while offering the ease and efficiency of shorter treatment administration time.
authors.affiliation: Division of Pediatric Emergency Medicine, Children's Memorial Hospital, Chicago, Illinois, USA. david.gutglass-md@advocatehealth.com
authors.forename: D J
authors.initials: DJ
authors.lastname: Gutglass
authors.forename: L
authors.initials: L
authors.lastname: Hampers
authors.forename: G
authors.initials: G
authors.lastname: Roosevelt
authors.forename: D
authors.initials: D
authors.lastname: Teoh
authors.forename: S R
authors.initials: SR
authors.lastname: Nimmagadda
authors.forename: S E
authors.initials: SE
authors.lastname: Krug
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000336:Aerosols; D000420:Albuterol / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002648:Child; D004334:Drug Administration Schedule; D004636:Emergency Service, Hospital; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D010366:Peak Expiratory Flow Rate; D016037:Single-Blind Method
chemical_list: D000336:Aerosols; D001993:Bronchodilator Agents; D000420:Albuterol