Acute asthma:How often should albuterol be given with a spacer?

Jill P. Karpel, K. Guguchev, A. Gaitan-Salas, R. Pathaparti, D. Prezant, T. K. Aldrich

Research output: Contribution to journalArticlepeer-review


Purpose: Beta-agonists given by MDI's attached to spacers provide equal bronchodilatation to wet nebulizers. Our purpose was to determine the optimal dosing interval for patients with acute asthma in the Emergency Department (ED). Methods: In the ED at entry (T-0), 101 asthma patients received albuterol (6 puffs) via an MDI attached to a spacer (Ellipse). They were then randomized to receive 6 puffs of albuterol or placebo with the Ellipse at 30, 60, or 90 min, such that Group 1 (n=34) received albuterol every 30 min, Group 2 (n=34) every 60 min and Group 3 (n=33) only at T-0. FEV-1 and vital signs were measured at the intervals in Figure 1. Potassium levels were measured at T-0 and T-120. Results: At T-0 the groups did not differ in age or FEV-1. All groups showed significant improvement in FEV-1 (p<0.05 T-0 vs T-120). However, at T-120 Groups 1 & 2 had significantly greater change in FEV-1 than Group 3 (p<0.05- Figure 1), but Groups 1 & 2 were not significantly different from each other (Figure 1). Mean heart rate increased 9, 8.5. and 4.3 beats/min for Groups 1, 2 and 3 (NS). Potassium levels did not significantly change during the study. Adverse effects and hospitalization rates were equivalent. Conclusion: For acute asthma, albuterol can optimally be given at 60 min intervals with an MDI and spacer with minimal adverse effects. Clinical Implications: For the majority of patients, more frequent albuterol treatments than at 60 min are not medically justified and add unnecessary expense and time commitments for ED staff. Supported by Glaxo Wellcome Inc (Graph Presented).

Original languageEnglish (US)
Pages (from-to)39S
Issue number4 SUPPL.
StatePublished - Oct 1 1996

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine


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