MDI with spacer as effective as nebulisers in asthma attacks
Using a metered-dose inhaler with a spacer device to deliver beta-2 agonists during an acute asthma attack is at least as effective as using nebulisers, according to an updated review published in the current issue
of The Cochrane Library (2006,
issue 2).
The review includes 2,066 children and 614 adults in 25 trials conducted
in accident and emergency departments and in the community. It also includes
213 children and 28 adults in six trials of inpatients with asthma. The
reviewers found that method of delivery of beta-2 agonists did not affect
hospital admission rates; the relative risk of admission for children
using a space was 0.65 (95 per cent confidence interval 0.4–1.06).
In addition, they noted that length of stay in accident and emergency
was significantly shorter when a spacer device was used in children,
with a mean difference of –0.47 hours (CI –0.58 to –0.37).
Pulse rate was lower for children using spacer devices compared with
those given nebulisers.
In adults, the relative risk of admission was 0.97 (CI 0.63–1.49)
and length of stay was not affected. Peak flow and forced expiratory
volume were similar for the two delivery methods in adults and children.
The reviewers conclude that spacers may have some advantages compared
with nebulisers for children with acute asthma. |
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