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Titolo:
High-dose albuterol by metered-dose inhaler plus a spacer device versus nebulization in preschool children with recurrent wheezing: A double-blind, randomized equivalence trial
Autore:
Ploin, D; Chapuis, FR; Stamm, D; Robert, J; David, L; Chatelain, PG; Dutau, G; Floret, D;
Indirizzi:
Hospices Civils, Hop Edouard Herriot, Serv Urgence & Reanimat Pediat, F-69437 Lyon 03, France Hospices Civils Lyon France 03 Reanimat Pediat, F-69437 Lyon 03, France Hospices Civils, Hop Debrousse, Unite Accueil Urgences Pediat, Lyon, France Hospices Civils Lyon France Unite Accueil Urgences Pediat, Lyon, France Hospices Civils, Dept Med Informat, Unite Rech Clin, Lyon, France HospicesCivils Lyon France Med Informat, Unite Rech Clin, Lyon, France Hospices Civils, Hop Edouard Herriot, Dept Pediat, Lyon, France Hospices Civils Lyon France Edouard Herriot, Dept Pediat, Lyon, France Hop Enfants, Serv Pneumol Allergol Pediat, Toulouse, France Hop Enfants Toulouse France v Pneumol Allergol Pediat, Toulouse, France
Titolo Testata:
PEDIATRICS
fascicolo: 2, volume: 106, anno: 2000,
pagine: 311 - 317
SICI:
0031-4005(200008)106:2<311:HABMIP>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE ASTHMA; NEBULIZERS; INFANTS;
Keywords:
recurrent wheezing; asthma; preschool children; inhaled albuterol; spacer device; metered-dose inhaler; nebulizer; equivalence trial; randomized trial; acceptability;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Floret, D Hospices Civils, Hop Edouard Herriot, Serv Urgence & Reanimat Pediat, Pl Arsonval, F-69437 Lyon 03, France Hospices Civils Pl Arsonval Lyon France 03 9437 Lyon 03, France
Citazione:
D. Ploin et al., "High-dose albuterol by metered-dose inhaler plus a spacer device versus nebulization in preschool children with recurrent wheezing: A double-blind, randomized equivalence trial", PEDIATRICS, 106(2), 2000, pp. 311-317

Abstract

Inhaled albuterol is the most frequently used bronchodilator for acute wheezing, and nebulization is the standard mode of delivery in hospital setting. However, recent guidelines consider spacer devices as an easier to use, and cost-saving alternative and recommend the high-dose metered-dose inhaler bronchodilator. Objective. To demonstrate clinical equivalence between a spacer device anda nebulizer for albuterol administration. Design. Randomized, double-blind, parallel group equivalence trial. Setting. Pediatric emergency wards at 2 tertiary teaching hospitals. Patients. Sixty-four 12- to 60-month-old children with acute recurrent wheezing (32 per group). Interventions. Albuterol was administered through the spacer device (50 mug/kg) or through the nebulizer (150 mu g/kg) and repeated 3 times at 20-minute intervals. Parents completed a questionnaire. Outcome Measures. Pulmonary index, hospitalization, ease of use, acceptability, and pulse oximetry saturation. Results. The 90% confidence interval of the difference between treatment groups for the median absolute changes in pulmonary index values between T0 and T60 was [-1; +1] and was included in the equivalence interval [-1.5; +1.5]. Clinical improvement increased with time. Less than 10% of the children (3 in each group) required hospitalization (2 in each group attributable to treatment failure). Parents considered administration of albuterol usingthe spacer device easier (94%) and better accepted by their children (62%). Conclusions. The efficacy of albuterol administered using the spacer device was equivalent to that of the nebulizer. Given its high tolerance, repeated 50-mu g/kg doses of albuterol administered through the spacer device should be considered in hospital emergency departments as first-line therapy for wheezing.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 00:52:56