The Effectiveness of Two Different Methods of Salbutamol Nebulization in Children with Asthma

Background: Short acting beta-2 agonists (SABA) inhalation is commonly used in bronchodilatatory test, which is still an important research tool in the diagnosis of respiratory diseases with bronchial obstruction. Bronchodilatatory effect of SABA depends primarily on the degree of patency of the airway, the type and dose of SABA, as well as the type of inhaler and inhalation technique. The aim of the study was to evaluate the spirometric effectiveness of two different methods of salbutamol nebulization in asthmatic children. Methods: The study group included 132 children aged 6-18 years (mean: 11.7), 91 (69%) boys and 41 (31%) girls with partly controlled asthma treated in the Allergy or Pulmonology Outpatient Clinics in Children's University Hospital in Lublin. The study was randomized and single blind design. Patients were randomly assigned to one of two groups. The first group used 2.2 mg of salbutamol (mean calculated dose) in the breath-actuated nebulizer (BAN) (Marine, Medbryt, Poland), while the second one - 5 mg salbutamol (constans dose) in the constant-output nebulizer (CON) (Porta-Neb, MEDIC-AID, UK). Flow-volume curve (dynamic spirometry) was measured before and 20 min. after drug nebulization (bronchodilatatory test). FEV1 (expiratory volume in first second) and FEF25-75 (forced expiratory flow at 25-75% of forced vital capacity) values were analyzed. The change in FEV1 and FEF25-75 after treatment with respect to baseline was calculated. Results: The mean baseline value of FEV1 was 67,4% in BAN and 70,5% in CON group and there was no statistical difference between these groups. The significant improvement of measured ventilatory parameters was observed. There was the significant difference in the bronchodilator response to salbutamol between two methods of nebulization. The value of FEV1 increased at 16,2% in BAN group and at 12,6% in CON group (p=0,026). The value of FEF25-75 increased in both groups at 37,7% and 32,7% respectively and there was no statistical difference between these groups. Conclusions: 1. We observed greater bronchodilatatory effect of salbutamol inhaled via breath-actuated nebulizer while delivering a double lower dose. 2. Bronchodilatatory test using nebulized salbutamol in breath-actuated nebulizer should be recommended for children.