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Right arrow Emergency Medicine

PEDIATRICS Vol. 105 No. 5 May 2000, p. e67

ELECTRONIC ARTICLE:
Undiluted Albuterol Aerosols in the Pediatric Emergency Department

Received Aug 16, 1999; accepted Dec 7, 1999.

David J. Gutglass*, Louis Hampers*, Genie Roosevelt*, Doreen Teoh*, Sai R. NimmagaddaDagger , and Steven E. Krug*

From the Divisions of * Pediatric Emergency Medicine and Dagger  Allergy, Children's Memorial Hospital, Chicago, Illinois.

Objective.  To evaluate the efficacy and efficiency of a short treatment method of administering albuterol aerosols.

Methods.  Fifty children 6 to 18 years of age with severe acute asthma (peak flow rates <60% of predicted) were enrolled in a single-blind, controlled trial in an urban pediatric emergency department. Patients were randomized to receive either the study short treatment (3.5 mL of undiluted albuterol nebulized for 20 inhalations) or the control treatment (albuterol diluted [.5 mL] and nebulized in normal saline [3 mL]) every 20 minutes for a total of 3 treatments. Peak flow and spirometric measurements were performed before and after each treatment.

Results.  There were 25 patients in the study group and 25 in the control group. There were no demographic differences between groups; both had comparable pulmonary function at presentation. The mean forced expiratory volume in 1 second percent predicted improvement between 0 and 60 minutes was 18.8% in the study group and 14.5% in the control group. The total time of treatment delivery for the study group was 6.4 minutes versus 32.7 minutes for the control group.

Conclusion.  Undiluted albuterol short treatments seem to be as effective as standard diluted albuterol in severe asthmatics, while offering the ease and efficiency of shorter treatment administration time.  Key words:  peak flow, forced expiratory volume in 1 second, spirometry, clinical asthma score, cost analysis.




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