title: Management of acute asthma in children using metered dose inhaler and small volume nebulizer.
abstract: OBJECTIVE
  To determine whether the administration of beta2-agonist by Metered Dose inhaler (MDI) with accessory device (AD) is a as effective as the administration of beta2-agonist by small volume nebulizers (SVN) for the treatment of acute asthma.
  
  
  METHODS
  A cross sectional study was conducted at Emergency Room (ER) of National Institute of Child Health (NICH), Karachi, between October 2000 to March 2001. This study included 150 children, 6 months and older with a history of wheeze and presenting with an acute asthma exacerbation. Children were categorized into mild, moderate and severe asthma according to medical scoring system. Children were assigned randomly into group A and B to receive standard dose of beta2-agonist (salbutamol) by MDI/AD (group A) or SVN (group B). Baseline characteristics and asthma severity were recorded. All variables (dyspnoea, use of accessory muscles, cyanosis, respiratory rate, heart rate, blood pressure, oxygen saturation, pulsus paradoxus, and wheeze) and Peak Expiratory Flow Rate (PEFR) in children 5 years and older, were determined at pre and post inhalation therapy.
  
  
  RESULTS
  Both groups did not differ in demographic characteristics. There were no significant differences in outcome measures. In children treated with MDI/ADs and SVNs. PEFR increased significantly in both the groups after completion of treatment, but PEFR was not statistically significant when compared in between groups.
  
  
  CONCLUSIONS
  The data suggested that MDI/AD is an effective alternative to nebulizer for the treatment of children with acute asthma exacerbation in the ER.
authors.affiliation: Department of Pediatrics, Jinnah Medical and Dental College, Karachi.
authors.forename: Syed Waseem
authors.initials: SW
authors.lastname: Jamalvi
authors.forename: Syed Jamal
authors.initials: SJ
authors.lastname: Raza
authors.forename: Farah
authors.initials: F
authors.lastname: Naz
authors.forename: Samina
authors.initials: S
authors.lastname: Shamim
authors.forename: S M Zia-ul-Wahab
authors.initials: SM
authors.lastname: Jamalvi
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000336:Aerosols; D000420:Albuterol / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D036501:Metered Dose Inhalers; D009330:Nebulizers and Vaporizers; D010154:Pakistan
chemical_list: D000318:Adrenergic beta-Agonists; D000336:Aerosols; D001993:Bronchodilator Agents; D000420:Albuterol