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June 1989

Experience With a Metered-Dose Inhaler With a Spacer in the Pediatric Emergency Department

Author Affiliations

From the Childrens Hospital Medical Center, Oakland, Calif.

Am J Dis Child. 1989;143(6):678-681. doi:10.1001/archpedi.1989.02150180056020

• Studies of adults suggest that metered-dose inhalers with spacers are as effective as hand-held nebulizers for bronchodilator delivery. We studied 13 children with acute asthma. They received two puffs every 2 minutes from metereddose inhalers with spacers (range, 4 to 14 puffs) titrated until improvement stopped. Peak expiratory flow increased 34% for metered-dose inhalers with spacers after the first 2 puffs and increased 87% for metered-dose inhalers with spacers after dose titration. After titration, respiratory rate decreased by 12%, heart rate increased by 2%, and breath sounds improved in 92% of the patients. We concluded that the metered-dose inhalers with spacers are an effective device for the treatment of asthma in the pediatric emergency department and that the use of metered-dose inhalers with spacers with titration can achieve significant bronchodilation in the treatment of patients with acute asthma.

(AJDC. 1989;143:678-681)

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