Efficacy of metered-dose inhalers for children with acute asthma exacerbations.
Pediatr Pulmonol
; 46(5): 421-7, 2011 May.
Article
in En
| MEDLINE
| ID: mdl-21194171
ABSTRACT
OBJECTIVE:
To compare the effectiveness of the administration of inhaled beta-agonists delivered via a metered-dose inhaler (MDI) with spacers--as part of an evidence-based asthma pathway developed to manage acute asthma exacerbations in children at the emergency room level and in inpatient management--against administration via nebulization.DESIGN:
Case with historical control.SETTING:
KK Women's and Children's Hospital (Singapore).PARTICIPANTS:
A total of 19,951 children (infants to older children) aged 18 years and younger who attended the emergency room for asthma exacerbations. MAIN OUTCOMEMEASURES:
Average length of stay, proportion admitted to high dependency or intensive care, proportion readmitted for unresolved symptoms within 72 hr, cost per patient and overall.RESULTS:
There was no increase in the mean proportion of emergency room attendances admitted to inpatient care with use of an MDI (mean difference 0.97%, 95% CI -1.6-3.5%, P = 0.447), nor of children admitted to intensive care (0.21 vs. 0.20 pre- and post-pathway, P = 0.827) or to high dependency units (2.21 vs. 1.37 pre- and post-pathway, P = 0.200) but a significant reduction in the within 72 hr re-attendance rate (mean difference 1.4%, 95% CI 0.78-2.0%, P < 0.001) with use of an MDI. The average length and cost per patient for an inpatient stay for acute asthma exacerbations was reduced with use of an MDI.CONCLUSIONS:
The use of an MDI with spacer as part of an evidence-based asthma pathway was effective in the management of acute asthma exacerbations in the emergency room setting and for inpatient management.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Asthma
/
Adrenergic beta-Agonists
/
Metered Dose Inhalers
Limits:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
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Infant
/
Newborn
Country/Region as subject:
Asia
Language:
En
Journal:
Pediatr Pulmonol
Journal subject:
PEDIATRIA
Year:
2011
Document type:
Article
Affiliation country: