Home-made spacers for bronchodilator therapy in children with acute asthma: a randomised trial

Zar, Heather J.; Brown, Gordon D.; Donson, H; Brathwaite, N.; Mann, Vipul; Weinberg, Eugene

doi:10.1016/s0140-6736(98)12445-5

Cited by 73 publications

(50 citation statements)

References 16 publications

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“…(1,2,4,5) Various studies have shown that the use of MDIs attached to a spacer, be it conventional or homemade, is as effective as is that of conventional nebulization. (7)(8)(9)(10) In choosing between using MDIs and nebulization, another important aspect to be considered is the cost. Studies conducted in the United States (11) and in Brazil (12) have shown that MDIs are more economical than are nebulizers.…”

Section: Resultsmentioning

confidence: 99%

Manejo de crises asmáticas em crianças: conhecimento de profissionais de saúde quanto ao tópico em hospitais-escola do Recife (PE)

2011

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Objective: Knowledge of acute asthma management in children is a subject that has rarely been explored. The objective of this study was to assess the level of such knowledge among health professionals in the city of Recife, Brazil. Methods: This was a cross-sectional survey involving 27 pediatricians and 7 nurses, all with at least two years of professional experience, at two large pediatric teaching hospitals in Recife. The participants completed a self-administered multiple-choice questionnaire. Results: The pediatricians and nurses all possessed insufficient knowledge regarding the use of metered dose inhalers, nebulization, and types/doses of medications, as well as techniques for decontamination and disinfection of the equipment. Conclusions: Insufficient knowledge of acute asthma management in children can lead to less effective treatment in hospitals such as those evaluated here. Educational programs should be developed in order to minimize this problem.Keywords: Asthma; Health knowledge, attitudes, practice; Nebulizers and vaporizers. ResumoObjetivo: O conhecimento sobre o manejo da asma aguda em crianças é um tema pouco explorado. O objetivo deste estudo foi avaliar o conhecimento de profissionais de saúde do Recife (PE) sobre o assunto. Métodos: Estudo transversal de tipo inquérito com 27 médicos e 7 enfermeiros, com mais de 2 anos de trabalho, de dois grandes hospitais-escola de pediatria do Recife, avaliados através de questionários autoaplicáveis com questões fechadas. Resultados: Tanto os pediatras quanto os enfermeiros apresentaram conhecimento inadequado sobre o uso de inaladores dosimetrados, nebulização, tipo e dosagem dos medicamentos, assim como técnicas de descontaminação e desinfecção do material. Conclusões: O conhecimento inadequado do manejo da asma aguda em crianças pode refletir em um tratamento menos efetivo nesses hospitais. Medidas educativas são necessárias para minimizar o problema.Descritores: Asma; Conhecimentos, atitudes e prática em saúde; Nebulizadores e vaporizadores. Original ArticleAcute asthma management in children: knowledge of the topic among health professionals at teaching hospitals in the city of Recife, Brazil J Bras Pneumol. 2011;37(5):584-588

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Section: Resultsmentioning

confidence: 99%

Manejo de crises asmáticas em crianças: conhecimento de profissionais de saúde quanto ao tópico em hospitais-escola do Recife (PE)

2011

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“…Foi utilizado fenoterol em inalador dosimetrado com Aerochamber ® , garrafa plástica de 500 ml vedada com cola, garrafa plástica de 500 ml não vedada e copo plástico de 200 ml. Houve melhora significativa na função pulmonar com o uso de espaçador industrial e garrafa plástica vedada com cola em relação à garrafa não vedada e ao copo plástico 3 .…”

Section: Discussionunclassified

Different inhaler devices in acute asthma attacks: a randomized, double-blind, placebo-controlled study

et al. 2005

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Objective: To verify the efficacy, side effects, and cost of treatment of acute asthma attacks, using different inhaler devices.Methods: This is a randomized, double-blind, placebo-controlled study. Salbutamol was administered via a nebulizer, a metered-dose inhaler (attached to a commercially available spacer device), a homemade non-valved spacer device, or a dry powder inhaler. Assessments were made at zero, 20, 40 and 60 minutes, followed by the application of salbutamol and placebo with another device. Forty children (mean age of 11±3.5 years) with acute asthma attacks, were evaluated. Clinical score, forced expiratory volume in one second and side effects were analyzed. The costs for medication and spacer devices were calculated.Results: There is no difference between groups regarding clinical score and variation of forced expiratory volume in one second. There was a major variation in the heart rate response to the nebulizer (35%) compared to the commercially available spacer and dry powder inhaler (15 and 17%) and between the homemade spacer and the commercially available spacer (28 and 15%) (p = 0.004). The nebulizer and homemade spacer caused more tremor (p = 0.02). The cost of treatment was higher for the nebulizer and commercially available spacer (p = 0.0001). Conclusions:The nebulizer was more expensive and used more medicine, showing the same efficiency. The homemade spacer was cheaper, but presented more side effects. The commercially available spacer was as expensive as the nebulizer, although safer. The dry powder inhaler was cheaper, but, just as the homemade spacer, it also caused tachycardia.J Pediatr (Rio J). 2005;81(4):298-304: Nebulizers, metered-dose inhalers, inhalation spacers, homemade spacer, child. ResumoObjetivo: Verificar a eficácia, eventos adversos e custo do tratamento da crise aguda de asma, utilizando diferentes dispositivos inalatórios.Métodos: Estudo randomizado, duplo-cego e controlado com placebo. Foi utilizado salbutamol em nebulizador, inalador dosimetrado com espaçadores industrial e artesanal e inalador em pó. As avaliações foram feitas em 0, 20, 40 e 60 minutos, seguidas da aplicação de salbutamol e placebo em outro dispositivo. Foram avaliadas 40 crianças em crise aguda de asma, com média de idade = 11±3,5 anos. Utilizouse escore clínico e função pulmonar, e foram verificados eventos adversos. Foram calculados gastos com o medicamento e o dispositivo inalatório.Resultados: O escore clínico e a variação no volume expiratório forçado no primeiro segundo foram semelhantes entre os grupos ao final do estudo. Foi encontrada uma variação maior na freqüência cardíaca com o uso de nebulizador (35%) do que nos grupos que fizeram uso do espaçador industrial (15%) e do inalador em pó (17%), e também entre os espaçadores artesanal e industrial, 28 e 15%, respectivamente (p = 0,004). O nebulizador e o espaçador artesanal provocaram mais tremores (p = 0,02). O custo do tratamento por paciente foi maior nos grupos nebulizador e espaçador industrial, R$ 22,31 e R$ 16,58, re...

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“…Homemade spacers are as effective as commercial spacers in the treatment of acute asthma. [15,16] If using a pMDI and spacer with a mask, ensure that the mask fits closely onto the child's face. Frequent doses of β 2 -agonists are safe for the treatment of acute asthma (evidence A).…”

Section: Short-acting Beta-2 (β 2 )-Agonist Bronchodilatorsmentioning

confidence: 99%

Guideline for the management of acute asthma in children: 2013 update

et al. 2013

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Home-made spacers for bronchodilator therapy in children with acute asthma: a randomised trial

Cited by 73 publications

References 16 publications

Manejo de crises asmáticas em crianças: conhecimento de profissionais de saúde quanto ao tópico em hospitais-escola do Recife (PE)

Manejo de crises asmáticas em crianças: conhecimento de profissionais de saúde quanto ao tópico em hospitais-escola do Recife (PE)

Different inhaler devices in acute asthma attacks: a randomized, double-blind, placebo-controlled study

Guideline for the management of acute asthma in children: 2013 update

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