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Equivalence of Continuous Flow Nebulizer and Metered-Dose Inhaler with Reservoir Bag for Treatment of Acute Airflow Obstruction
Section snippets
Subjects
The study was conducted in the emergency room of San Francisco General Hospital, a 582-bed acute care facility. Seventy-five patients (45 men and 30 women), mean age 44 ± 16, who presented with acute airflow obstruction (mean FEV1 1.06 L ± 0.47) were prospectively assigned into COPD and asthma groups according to the following criteria:
COPD—≥10 pack-years smoking and onset of symptoms ≥ age 30
Asthma—<10 pack-years smoking or onset of symptoms <age 30
Patients were excluded from the study if they
RESULTS
There were 101 subjects evaluated for participation in the study, but 26 were excluded because they did not meet the entry criteria or had participated in the study during a previous emergency room visit. Subjects randomized to the two treatments were well matched at baseline within the diagnostic groups for age, sex, pack years of smoking, serum theophylline levels, FEV1, and dyspnea scores (Table 1), as well as pulse rate, respiratory rate, and blood pressure (Table 2). In the 53 patients
DISCUSSION
We were unable to demonstrate that bronchodilator therapy with the nebulizer was preferable to the MDI with reservoir spacer for the administration of metaproterenol aerosol to subjects who presented to the emergency room with acute asthma or COPD. The results of the present study indicate that the MDI with InspirEase and the compressor driven nebulizer produce not only equivalent bronchodilation, but also equivalent improvement in dyspnea. Furthermore, the two methods of delivery resulted in
ACKNOWLEDGMENT
The authors wish to thank David Rose and Dorothy Ladd for their assistance in preparation of this manuscript.
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GEMA 5.3. Spanish Guideline on the Management of Asthma
2023, Open Respiratory ArchivesEfficacy and cost comparisons of bronchodilatator administration between metered dose inhalers with disposable spacers and nebulizers for acute asthma treatment
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Manuscript received June 15; revision accepted August 17.