Continuous versus intermittent albuterol nebulization in the treatment of acute asthma

doi:10.1016/S0196-0644(05)80412-3

Annals of Emergency Medicine

Volume 22, Issue 12, December 1993, Pages 1847-1853

https://doi.org/10.1016/S0196-0644(05)80412-3 Get rights and content

Study objectives:

To compare bronchodilation, chronotropic effects, and side effects of the same dose of nebulized albuterol when given by either intermittent or continuous administration.

Design:

A randomized assignment of patients to one of the two methods of albuterol nebulization.

Setting:

Adult emergency department in an urban public hospital.

Type of participants:

Adult patients with acute exacerbations of asthma.

Interventions:

Administration of 30 mg albuterol given over 110 minutes by either continuous or intermittent aerosolization.

Measurements:

FEV₁, forced vital capacity, heart rate, and systolic and diastolic blood pressures were measured immediately before treatment and then hourly for two hours. Side effects, symptoms, subsequent admission, and discharge also were noted.

Main results:

An overall significant decrease in heart rate was observed, indicating the lack of significant chronotropic effects with this dose of albuterol. Both treatments resulted in significant spirometric improvement without a significant treatment difference for the entire group. A difference, however, was found in the relative rates of FEV₁ improvement with the two treatments depending on whether patients had an initial FEV₁ less than or more than 50% predicted (P = .05). A secondary analysis on patients with an initial FEV₁ less than percent predicted demonstrated a higher rate of percent predicted FEV₁ increase with the continuously nebulized albuterol group (P = .03).

Conclusion:

This study demonstrates that albuterol can be given safely at this dose by either intermittent or continuous nebulization. Future studies should examine whether continuous nebulization has a reproducible advantage over intermittent nebulization in patients with more severe obstruction.

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Original contributionContinuous versus intermittent albuterol nebulization in the treatment of acute asthma

Study objectives:

Design:

Setting:

Type of participants:

Interventions:

Measurements:

Main results:

Conclusion:

J Allergy Clin Immunol

Chest

Am J Med

Chest

J Allergy Clin Immunol

Mayo Clin Proc

Changing patterns of asthma mortality: Identifying target populations at risk

JAMA

Original contribution
Continuous versus intermittent albuterol nebulization in the treatment of acute asthma