การศึกษาเปรียบเทียบการให้ยาซาลบูทามอลทางเอ็มดีไอร่วมกับสเปซเซอร์และทางเจ็ทเนบูไลเซอร์ในผู้ป่วยเด็กเล็กที่หายใจมีเสียงหวีด / วิภารัตน์ มนุญากร = A prospective randomized controlled trial of salbutamol aerosol therapy via metered dose inhaler-spacer versus jet nebulizer for young children with acute wheezing / Wiparat Manuyakorn
Studies efficacy and side effect of salbutamol aerosol therapy via Metered Dose Inhaler-spacer (MDI-spacer) compared with jet nebulizer in young children with acute wheezing. Design: Prospective randomized double blind placebo controlled clinical trial. Setting: Pediatric in-patient ward, King Chulalongkorn Memorial Hospital, Bangkok. Patients: Children up to 5 years of age who had wheezing associated with respiratory tract infection and were admitted to the Department of Pediatrics, King Chulalongkorn Memorial Hospital. Method: All the studied children were examined and their clinical scores before and after salbutamol aerosol therapy were recorded. The pulmonary function tests (tidal breathing) were performed to measure parameters from flow volume loop (%V-PF, Tp/Te, 25/PF), Crs (compliance) and Rrs (resistance) before and after salbutamol aerosol therapy. The patients were classified into two groups by restricted randomization. The first group (jet nebulizer group) recieved placebo 2 puffs via MDI-spacerand then salbutamol (0.5% VentolinR respiratory solution) 0.15 mg/kg via jet nebulizer. The second group (MDI-spacer group) recieved salbutamol MDI 2 puff via spacer and then placebo via jet nebulizer. Percent improvement in parameters from flow volume loop, Crs, Rrs, clinical score, respirarory rate, heart rate and oxygen saturation after salbutamol aerosol therapy in both groups were compared by Mann-Whitney U Test Result: A total of 34 wheezing children underwent pulmonary function tests before and after salbutamol aerosol therapy (17 via MDI-spacer and 17 via jet nebulizer). Percent improvement in Crs/kg, Rrs, %VF, Tp/Te, 25/PF and clinical score were not statistically different in both groups. But post bronchodilator heart rate in the jet nebulizer group was significantly increased. (p=0.002) Conclusion: Efficacy of salbutamol aerosol therapy via MDI-spacer compared with jet nebulizer in young children with acute wheezing was not different in terms of percent improvement in pulmonary function test andclinical score. However, salbutamol aerosol therapy via jet nebulizer caused significantly higher heart rate than MDI-spacer.