title: The efficacy of metered-dose inhalers with a spacer device in the pediatric setting.
abstract: OBJECTIVE
  To systematically review the published research and report on the efficacy of using a metered-dose inhaler with a spacer (MDI-S) device in a pediatric setting to treat acute exacerbations of asthma.
  
  
  METHODS
  A literature search was conducted on the CINAHL, Medline, and Cochrane databases; additional searches were made by hand from the reference lists in each study retrieved from databases and from review articles written on the same topic.
  
  
  CONCLUSIONS
  This critical appraisal of the research demonstrates the MDI-S is as effective as the nebulizer, faster in the delivery of medication, and cost-effective.
  
  
  CONCLUSIONS
  No significant difference between the MDI-S and nebulizer in delivering medication in an acute exacerbation of asthma was found in this analysis. The practitioner's choice of delivery methods should reflect the family's preference, the practice situation, and economic considerations.
authors.affiliation: Rural Health Clinic, Monahans, Texas, USA. lbuxton@earthlink.net
authors.forename: Lance J
authors.initials: LJ
authors.lastname: Buxton
authors.forename: Joan H
authors.initials: JH
authors.lastname: Baldwin
authors.forename: Judith A
authors.initials: JA
authors.lastname: Berry
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Mandleco
mesh_terms: D000208:Acute Disease; D000280:Administration, Inhalation; D000367:Age Factors; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000145:classification / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D019317:Evidence-Based Medicine; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009330:Nebulizers and Vaporizers / Q000191:economics / Q000592:standards* / Q000600:supply & distribution; D018579:Patient Selection; D010372:Pediatrics / Q000379:methods; D012720:Severity of Illness Index
chemical_list: D018927:Anti-Asthmatic Agents