title: Treatment of asthma exacerbations with the human-powered nebuliser: a randomised parallel-group clinical trial.
abstract: BACKGROUND
  Nebulisers aid the treatment of respiratory diseases, including asthma, but they require electricity and are often cost-prohibitive for low- and middle-income countries.
  
  
  OBJECTIVE
  The aim of this study was to compare a low-cost, human-powered nebuliser compressor with an electric nebuliser compressor for the treatment of mild to moderate asthma exacerbations in adults and children.
  
  
  METHODS
  This was a non-blinded, parallel-group, equivalence study, with 110 subjects between 6 and 65 years of age, conducted in the emergency department of a district hospital in Ilopango, El Salvador. Participants were assigned by random allocation to receive a 2.5-mg dose of salbutamol from the experimental human-powered nebuliser or the electric nebuliser control. All assigned participants completed treatment and were included in analysis. The study was not blinded as this was clinically unfeasible; however, data analysis was blinded.
  
  
  RESULTS
  The mean improvement in peak flow of the experimental and control groups was 37.5 (95% confidence interval (CI) 26.7-48.2) l/min and 38.7 (95% CI, 26.1-51.3) l/min, respectively, with a mean difference of 1.3 (95% CI, -15.1 to 17.7) l/min. The mean improvement in percent-expected peak flow for the experimental and control groups was 12.3% (95% CI, 9.1-15.5%) and 13.8% (95% CI, 9.8-17.9%), respectively, with a mean difference of 1.5% (95% CI, -3.6 to 6.6%).
  
  
  CONCLUSIONS
  The human-powered nebuliser compressor is equivalent to a standard nebuliser compressor for the treatment of mild-to-moderate asthma. (Funded by the Opus Dean's Fund, Marquette University College of Engineering; ClinicalTrials.gov NCT01795742.).
authors: 1] Department of Biomedical Engineering, Marquette University, Milwaukee, WI, USA [2] School of Medicine, University of Washington, Seattle, WA, USA.
authors: Christopher J
authors: CJ
authors: Hallberg
authors: Institute of Pastoral Studies and Neiswanger Institute of Bioethics, Stritch School of Medicine, Loyola University Chicago, Chicago, IL, USA.
authors: M Therese
authors: MT
authors: Lysaught
authors: 1] Department of Medicine, Universidad Salvadoreña Alberto Masferrer, San Salvador, El Salvador [2] Department of Medicine, Universidad José Matías Delgado, Antiguo Cuscatlán, El Salvador.
authors: René Antonio
authors: RA
authors: Najarro
authors: 1] Department of Medicine, Universidad Salvadoreña Alberto Masferrer, San Salvador, El Salvador [2] Department of Medicine, Universidad José Matías Delgado, Antiguo Cuscatlán, El Salvador.
authors: Fausto
authors: F
authors: Cea Gil
authors: Casa de la Soladaridad Program, Santa Clara University, Santa Clara, CA, USA.
authors: Clara
authors: C
authors: Villatoro
authors: Department of Medicine, Universidad Salvadoreña Alberto Masferrer, San Salvador, El Salvador.
authors: Ana Celia
authors: AC
authors: Diaz de Uriarte
authors: Department of Biomedical Engineering, Marquette University, Milwaukee, WI, USA.
authors: Lars E
authors: LE
authors: Olson
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000368:Aged; D000420:Albuterol / Q000008:administration & dosage / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers / Q000706:statistics & numerical data; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018927:Anti-Asthmatic Agents; D000420:Albuterol