Department of Respiratory Care, Research, Children's Hospital and Research Center Oakland, Oakland, California 94609, USA.
Respir Care. 2011 Jun;56(6):761-70. doi: 10.4187/respcare.00142. Epub 2011 Feb 11.
Bronchodilator treatment for asthma can be provided with various aerosol-generating devices and methods. There have been no randomized trials of a breath-actuated nebulizer versus continuous 1-hour nebulization and/or small-volume constant-output nebulizer in pediatric asthma patients.
We conducted a randomized study of one-time albuterol treatment with the AeroEclipse breath-actuated nebulizer versus standard therapy (single treatment via small-volume nebulizer or 1-hour of continuous nebulized albuterol) in pediatric asthma patients in the emergency department. Eligible patients were those admitted to the emergency department, 0 months to 18 years of age, who presented with asthma or wheezing. We assessed all the patients with our clinical asthma scoring system and peak-flow measurement if possible. We stratified the patients by clinical asthma score and weight, and then randomized them to receive their initial albuterol treatment in the emergency department via either AeroEclipse or standard therapy. We recorded time in the emergency department, change in clinical asthma score, need for additional bronchodilator treatments, need for admission, patient response, ability to actuate the AeroEclipse, and adverse effects.
We enrolled 149 patients between October 14, 2004 and November 11, 2005, and we randomized 84 patients to AeroEclipse and 65 to standard therapy. The cohort's average age was 5.5 years. There were no significant differences in demographics. The initial mean clinical asthma scores were 5.1 ± 2.4 in the AeroEclipse group, and 5.1 ± 2.1 in the standard-therapy group. Time in the emergency department was not different (AeroEclipse 102 min, standard therapy 125 min, P = .10), but the AeroEclipse group had a significantly greater improvement in clinical asthma score (1.9 ± 1.2 vs 1.2 ± 1.4, P = .001) and respiratory rate (P = .002), and significantly lower admission rate (38% vs 57%, P = .03). There was no difference in adverse effects.
Although AeroEclipse did not reduce the time in the ED, it significantly improved clinical asthma score, decreased admissions, and decreased respiratory rate.
支气管扩张剂治疗哮喘可采用各种雾化器和方法。目前还没有关于气动雾化器与持续 1 小时雾化和/或小容量恒流雾化器治疗儿科哮喘患者的随机试验。
我们进行了一项随机研究，比较了一次性沙丁胺醇治疗在儿科哮喘患者中的应用，这些患者在急诊科使用 AeroEclipse 气动雾化器，或使用标准疗法（小容量雾化器单次治疗或 1 小时持续雾化沙丁胺醇）。纳入的患者为因哮喘或喘息而在急诊科就诊的 0 个月至 18 岁患者。我们用我们的临床哮喘评分系统和最大呼气流速（PEF）测量尽可能地评估所有患者。我们按临床哮喘评分和体重对患者进行分层，然后将他们随机分配到急诊科接受初始沙丁胺醇治疗，方法是使用 AeroEclipse 或标准疗法。我们记录了患者在急诊科的时间、临床哮喘评分的变化、是否需要额外的支气管扩张剂治疗、是否需要住院、患者的反应、AeroEclipse 的驱动能力以及不良反应。
我们于 2004 年 10 月 14 日至 2005 年 11 月 11 日期间纳入了 149 名患者，并将 84 名患者随机分为 AeroEclipse 组，65 名患者分为标准治疗组。队列的平均年龄为 5.5 岁。两组患者的人口统计学特征无显著差异。AeroEclipse 组初始平均临床哮喘评分为 5.1±2.4，标准治疗组为 5.1±2.1。两组患者在急诊科的时间无显著差异（AeroEclipse 组 102 分钟，标准治疗组 125 分钟，P=0.10），但 AeroEclipse 组临床哮喘评分（1.9±1.2 比 1.2±1.4，P=0.001）和呼吸频率（P=0.002）的改善明显更大，住院率（38%比 57%，P=0.03）明显更低。两组不良反应无差异。
虽然 AeroEclipse 没有减少在急诊科的时间，但它明显改善了临床哮喘评分，降低了住院率，降低了呼吸频率。
