PICO Assignment Clinical question P- Pediatric age group patients with acute wheezing I- Albuterol administration using metered dose inhaler C-Albuterol administration using nebuliser O- Resolution of symptoms and side effects What event generated the clinical question?…
Patients frequently ask health care providers as to which is a better mode of administration in terms of efficacy, convenience and safety. This triggered me to find evidence to ascertain as to which of the two is a better mode of administration in acute wheezing. Thus, it was both problem focused and knowledge focused trigger that generated the clinical question. Names/Types of research sources used The research source used was PubMed. Summation of the research findings as related to the clinical question Rodrigo and Rodrigo (1998) performed a randomized, double-blind, parallel-group study to compare the efficacy of salbutamol (or albuterol) delivered by either metered-dose inhaler plus spacer (MDI-spacer) or by nebulization, and to determine the relationships between physiologic responses and plasma salbutamol concentrations. The study revealed that bronchodilatation remained same with metered dose inhalation and nebulization, but side effects were more with nebulization because of higher levels of plasma salbutamol due to increased absorption. Deerajanawong et al (2005) conducted a prospective randomized, double-blind, placebo-controlled trial with an aim to compare the efficacy of salbutamol aerosol therapy given metered dose inhaler and nebulization in young children with acute wheezing. ...
From the study, it was evident that metered dose inhalers are as efficacious as nebulization to administer albuterol in young children with wheezing. Infact, the study revealed that metered dose inhalers were more convenient in this regard. Integration of research findings Administration of albuterol can be done either through metered dose inhalers or nebulization in acute wheezing conditions in children. Both methods of administration are equally efficacious. However, nebulization is more time consuming and has risk of side effects. Potential practice changes based on research evidence Metered dose inhaler would be recommended as the preferred of administration of albuterol in children with acute wheezing since it is easier to administer, takes less time in the process, can be given anywhere and has less side effects References Deerojanawong, J., Manuyakorn, W., Prapphal, N., Harnruthakorn, C., Sritippayawan, S., Samransamruajkit, R. (2005). Randomized controlled trial of salbutamol aerosol therapy via metered dose inhaler-spacer vs. jet nebulizer in young children with wheezing. Pediatr Pulmonol., 39(5), 466-72. Delgado, A., Chou, K.J., Silver, E.J., Crain, E.F. (2003). Nebulizers vs metered-dose inhalers with spacers for bronchodilator therapy to treat wheezing in children aged 2 to 24 months in a pediatric emergency department. Arch Pediatr Adolesc Med., 157(1), 76-80. Rodrigo, C., and Rodrigo, G. (1998). Salbutamol treatment of acute severe asthma in the ED: MDI versus hand-held nebulizer. Am J Emerg Med., 16(7), ...
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