Breath-Actuated Nebulizer Versus Conventional Continuous-Output Nebulizer in Pediatric Asthma Patients

A Randomized Controlled Trial Comparing the Effectiveness of a Breath-Actuated Nebulizer Device Versus a Conventional Continuous-Output Nebulizer in Treating Pediatric Asthma Patients in the Emergency Department

A Breath-Actuated Nebulizer is a newer type of nebulizer device that creates aerosol only when a patient is inhaling, rather than creating aerosol continuously. It is thought that breath-actuated nebulizer devices may deliver asthma rescue medications to patients' lungs more effectively and therefore lead them to recover from asthma attacks faster than conventional continuous-output nebulizer devices. This study compares outcomes including hospital admission rates, number of nebulized treatments required, and patient/family satisfaction when a breath-actuated nebulizer device versus a conventional continuous-output nebulizer is used to deliver asthma medications to pediatric asthma patients in the emergency department.

Inclusion Criteria:

• children 1-17 years old with known history of asthma
• children must be presenting to the emergency department for treatment of acute asthma
• children must qualify to be treated for acute asthma according to an existing standardized asthma care algorithm

Exclusion Criteria:

• concomitant chronic respiratory or cardiac disease such as cystic fibrosis, congenital heart disease, or bronchopulmonary dysplasia
• no prior history of asthma
• pregnancy
• reported history of drug allergy to albuterol or ipratropium bromide
• previous participation in the study within the preceding three weeks
• vital sign instability/need for immediate emergency intervention to prevent clinical deterioration