Diferentes dispositivos inalatórios na crise aguda de asma : um estudo randomizado, duplo-cego, controlado com placebo

AUTOR(ES)
DATA DE PUBLICAÇÃO

2005

RESUMO

Children in acute asthma attacks must be treated with bronchodilators 2-agonists through aerosol therapy. There are some devices that generate aerosols for the use of these medicines. The aim of this study was: 1) to verify the efficacy of the nebulizer, metered-dose inhaler with commercially and home-made spacers, and dry powder inhaler in the treatment of the acute asthma attacks; 2) to verify adverse effects with the nebulizer, metered-dose inhaler with commercially and home-made spacers, and dry powder inhaler and 3) to verify the cost of the treatment of the acute asthma attacks using nebulizer, metered-dose inhaler with commercially and home-made spacers, and dry powder inhaler. A randomized, double-blind, placebo controlled study. To evaluate the efficacy it was verified clinical score and forced expiratory volume 1st second. Adverse effects as tachycardia, tremors, vomits and hypokalemia had been verified. The direct cost of the treatment of acute asthma was calculated, using medicine and device. We have evaluated children in acute asthma attacks, age  6 years and <18 years, without history of other cardiac and pulmonary illnesses. Forty children had been involved in the study, mean age 113,5 years. The distribution for age, sex, race, weight, height, forced expiratory volume 1st second in the beginning of the study was homogeneous between the 4 groups. The clinical score presented significant reduction 60 minutes later, however it did not have difference between the groups (p= 0.51). The percentage of variation of the forced expiratory volume 1st second was similar between the groups after 60 minutes (p= 0,96). Tremors had been more frequently in the group nebulizer and home-made spacer spacer (p= 0,0198). There is a greater variation of the heart beat in the group nebulizer and home-made spacer than commercially spacer. Home-made spacer caused similar tachycardia to the dry powder inhaler. The cost of the treatment of acute asthma attacks was more expensive using nebulizer and commercially spacer (p<0.0001). Nebulizer must be considered second line in the treatment of asthma. Commercially spacer is efficient and safe, however of high cost. Home-made spacer is efficient and must be used as alternative in the treatment of asthma, however with caution. Dry powder inhaler is efficient and cheap, but also it must be used with caution.

ASSUNTO(S)

nebulizadores e vaporizadores albuterol broncodilatadores asma em crianças medicina

ACESSO AO ARTIGO

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