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Original ArticleOpen Access
A Comparative Study of Efficacy of Salbutamol via Metered Dose Inhaler with Volumatic Spacer and via Dry Powder Inhaler, Easyhaler, to Nebulization in Mild to Moderate Severity Acute Asthma Exacerbation in Childhood
Vangveeravong M 
Background: Rapid-acting inhaled beta-2 agonist is standard treatment in acute asthmatic patient; it causes
smooth muscle dilatation, gives rapid action and has less side effect compared with parenteral and oral form.
There are many forms of inhaler including nebulization, MDI and DPI. In Thailand the most common form of
salbutamol administration for the treatment of acute exacerbation of asthma is via nebulization.
Objective: To compare the clinical effectiveness and side effects of salbutamol via MDI with Volumatic spacer
and via DPI (Easyhaler), with nebulization in mild to moderate severity of acute asthma exacerbation in
childhood.
Material and Method: A prospective, randomized controlled study in children, aged 5-18 years old with mild
to moderate severe asthmatic attack, is done at the Emergency Room, QSNICH during October 2004 to
February 2006. These children with acute asthma attack are randomly-assigned to 3 groups of different
salbutamol administrations: group 1 via nebulization, group 2 via MDI with volumatic spacer and group 3
via DPI (Easyhaler). Salbutamol is administered and clinical responses: asthma score, oxygen saturation, PR,
RR, BP and side effects (tremor and palpitation) are recorded at 0, 20, 40 and 60 minutes after the drug
administrations. The drug will be repeated every 20 minutes for the total maximum of 3 times. If there is no
clinical improvement, they will be admitted to the hospital for further management.
Results: There are 54 asthmatic children, 35 male (64.8%) and 19 female (35.2%). Their mean age is 8.4 + 2.3
years. There are 18 patients in each group. There is no significant difference in efficacy of salbutamol among
the 3 groups as measured by asthma score, O2 saturation, PR, RR and BP. Tremor are equally observed in all
3 groups (5.5%) while palpitation are observed in 11.1% of group 1 and 2 only. One patient in group 2 and 3
are admitted while no patient in group 1 is.
Conclusion: Rapid-acting inhaled beta-2 agonist via MDI with volumatic spacer and DPI (Easyhaler) can be
used effectively compared with nebulization form in treating mild to moderate degrees of acute exacerbation
of asthma in children with comparable side effects.
Keywords: Salbutamol, Nebulization, Metered dose inhaler, Volumatic spacer, Dry powder inhaler, Easyhaler
smooth muscle dilatation, gives rapid action and has less side effect compared with parenteral and oral form.
There are many forms of inhaler including nebulization, MDI and DPI. In Thailand the most common form of
salbutamol administration for the treatment of acute exacerbation of asthma is via nebulization.
Objective: To compare the clinical effectiveness and side effects of salbutamol via MDI with Volumatic spacer
and via DPI (Easyhaler), with nebulization in mild to moderate severity of acute asthma exacerbation in
childhood.
Material and Method: A prospective, randomized controlled study in children, aged 5-18 years old with mild
to moderate severe asthmatic attack, is done at the Emergency Room, QSNICH during October 2004 to
February 2006. These children with acute asthma attack are randomly-assigned to 3 groups of different
salbutamol administrations: group 1 via nebulization, group 2 via MDI with volumatic spacer and group 3
via DPI (Easyhaler). Salbutamol is administered and clinical responses: asthma score, oxygen saturation, PR,
RR, BP and side effects (tremor and palpitation) are recorded at 0, 20, 40 and 60 minutes after the drug
administrations. The drug will be repeated every 20 minutes for the total maximum of 3 times. If there is no
clinical improvement, they will be admitted to the hospital for further management.
Results: There are 54 asthmatic children, 35 male (64.8%) and 19 female (35.2%). Their mean age is 8.4 + 2.3
years. There are 18 patients in each group. There is no significant difference in efficacy of salbutamol among
the 3 groups as measured by asthma score, O2 saturation, PR, RR and BP. Tremor are equally observed in all
3 groups (5.5%) while palpitation are observed in 11.1% of group 1 and 2 only. One patient in group 2 and 3
are admitted while no patient in group 1 is.
Conclusion: Rapid-acting inhaled beta-2 agonist via MDI with volumatic spacer and DPI (Easyhaler) can be
used effectively compared with nebulization form in treating mild to moderate degrees of acute exacerbation
of asthma in children with comparable side effects.
Keywords: Salbutamol, Nebulization, Metered dose inhaler, Volumatic spacer, Dry powder inhaler, Easyhaler
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