Bronchodilator Response to Salbutamol Delivered by Metered Dose Inhaler with Spacer and Dry Powder Inhaler in Acute Asthma In Children: A Comparative Study

Background: Salbutamol inhalation is the mainstay of treatment for acute exacerbation of asthma. A number of delivery systems for asthma medication have been developed for children, each having its own advantages and disadvantages. This study was done to compare the bronchodilator effect of salbutamol inhalation delivered through metered dose inhaler (MDI) with spacer and dry powder inhaler (DPI) in children presenting with mild and moderate acute asthma. Methodology: Children of 6 to 15 years of age with mild or moderate acute exacerbation of asthma were assessed primarily and randomly distributed into two groups having equal number of patients and received 400micro-gram of salbutamol delivered by either MDI with spacer or DPI device. The primary outcome variable was peak expiratory flow rate (PEFR) and secondary outcome variables were percent predicted PEFR, heart rate, respiratory rate, oxygen saturation, wheezing and accessory muscle scores. Changes in primary and secondary outcome variables, before and after drug intervention were recorded and subjected to statistical tests for significance. Separate analyses were done for mild and moderate asthma patients. Results: The changes in primary outcome variable (PEFR) in both groups before and after intervention was 179.19 ± 33.27 vs. 197.52 ± 57.01 liters/min and 184.81 ± 59.65 vs. 202.83 ± 64.76 liters/min respectively, which was statistically highly significant (P= 0.001). Similar significant changes were also observed in case of secondary outcome variables. Conclusion: Bronchodilator response to salbutamol in mild or moderate acute asthma in children is similar when equal amount of drug is delivered either through an MDI with spacer or a DPI DOI: http://dx.doi.org/10.3329/bjch.v38i2.21138 Bangladesh J Child Health 2014; VOL 38 (2) : 62-67