Tips from Other Journals
Nebulizers vs. MDIs with Spacers for COPD or Asthma
FREE PREVIEW Log in or buy this issue to read the full article. AAFP members and paid subscribers get free access to all articles. Subscribe now.
FREE PREVIEW Subscribe or buy this issue. AAFP members and paid subscribers get free access to all articles.
Am Fam Physician. 1998 Jun 1;57(11):2836-2838.
Nebulizer treatment is recommended for the management of patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) or asthma who visit the emergency department for urgent care. However, nebulizer treatment requires special equipment and regular maintenance, uses up to 10 times more medication than metered-dose inhalers (MDIs) and is a potential source of contamination. Mandelberg and associates compared nebulizer treatment with therapy administered with an MDI and a spacer.
The study group consisted of 50 patients who presented to an emergency department for treatment of a severe respiratory event. Each patient was randomized to one of two groups. The first group received an MDI and a spacer with placebo followed by a nebulized treatment with medication. The second group received an MDI and spacer with medication and a nebulized treatment with placebo. The assigned treatment was repeated every 15 minutes up to three times unless the patient suffered significant side effects. Spirometry was performed initially and after each treatment. The patients and an investigator rated symptom response after the treatments.
The results of spirometry did not differ between the two groups. Subjective improvement, as rated by the patients and the investigators, did not differ.
The authors conclude that even in patients who present to the emergency department for treatment of severe airflow limitations, treatment with an MDI and a spacer is appropriate. This therapy can be as effective as nebulizer therapy, and it may reduce the cost of treatment in these patients. The use of an MDI with a spacer requires less equipment, reduces the demand on personnel time and can reduce the risk of contamination.
Mandelberg A, et al. Nebulized wet aerosol treatment in emergency department—is it essential? Chest. December 1997;112:1501–5.
Copyright © 1998 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact firstname.lastname@example.org for copyright questions and/or permission requests.
Want to use this article elsewhere? Get Permissions