Should metered-dose inhalers with spacers replace nebulizers for administering bronchodilators in managing acute bronchospasm?
Aerosol therapy, which delivers topical treatment directly to the airway, is the mainstay of asthma care. Compared with systemic administration, the lower medication doses used with aerosol inhalation result in fewer side effects, greater effectiveness, and faster onset of action. Using nebulizers to deliver bronchodilator aerosol has become part of the standard approach to acute asthma management. Several investigations have suggested, however, that metered-dose inhalers (MDI) with spacers also deliver bronchodilator effectively to children both in ambulatory care and during acute asthma exacerbations, conferring comparable clinical benefit and safety with lower cost, less personnel time, and greater convenience than nebulizer treatment.18-25 Optimal use of an MDI requires a specific technique (see Guides below: “How to use an inhaler” and “Tips on helping your infant or young child use an inhaler”). Dyspnea, tachypnea, and cough during acute asthma episodes can undermine a patient’s
