Comparison of two forms of albuterol for treatment of acute bronchospasm in pediatric patients.
BACKGROUND
The Circulaire nebulizer (C-Neb) is marketed as superior to low-dose albuterol for acute bronchospasm.


METHODS
This clinical trial design compared clinical and fiscal outcomes of patients treated with C-Neb and high-dose albuterol (HDA). Eligibility criteria included reactive airway disease, age >5 years, and asthma score (AS) of 2 to 10. Patients with odd medical record numbers received HDA, and those with even numbers received C-Neb. Treatment was concluded if AS was 0, peak flow was >70% predicted, or after three treatments.


RESULTS
One hundred eight patients were enrolled: 48 received HDA, 52 received C-Neb, and 8 were excluded. The two groups were comparable by admission rates (G2 = 0.90, P = 0.34), return visit rates (G2 = 0.73, P = 0.39), and final AS (z = 0.59, P = 0.55). Side effects were similar: change in heart rate (t = 1.61, P = 0.11) and mean arterial pressure (t = 1.36, P = 0.17). Charges per treatment, per delivery, and total charges were greater for HDA.


CONCLUSIONS
The C-Neb is equally effective, has similar side effects, and requires less time and charges than HDA.
Monroe
Kathy W
KW
Department of Pediatrics, Division of Emergency Medicine, University of Alabama at Birmingham, 35233, USA. kmonroe@peds.uab.edu
Nichols
Michele H
MH
King
William D
WD
Tucker
Kenya
K
Tomlinson
Randall
R
D000208:Acute Disease; D000280:Administration, Inhalation; D000367:Age Factors; D000420:Albuterol / Q000008:administration & dosage* / Q000627:therapeutic use*; D001986:Bronchial Spasm / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D002648:Child; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D009330:Nebulizers and Vaporizers; D017063:Outcome Assessment, Health Care; D010366:Peak Expiratory Flow Rate; D012720:Severity of Illness Index; D013997:Time Factors
D001993:Bronchodilator Agents; D000420:Albuterol