{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:58:16Z","timestamp":1790913496234,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":133,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To date, no studies have assessed the outcomes of different inhalation methods for procaterol, a short\u2010acting \u03b22\u2010agonist frequently used in Japan to treat acute asthma exacerbations in children. The present study compared the efficacy and safety of procaterol using a nebulizer (NEB) and a metered\u2010dose inhaler (MDI) with a spacer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The present before\u2010and\u2010after study targeted patients aged 4\u201316\u2009years with moderate to severe acute asthma exacerbations who visited the pediatric emergency department (PED). The primary outcome was a reduction in the Modified Pulmonary Index Score (MPIS), and the secondary outcomes were the hospitalization rate, length of stay (LOS), and incidence of adverse events. Propensity score matching and multiple regression analysis were conducted to adjust for confounding factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty\u2010nine patients were selected from 70 and 77 patients in the NEB and MDI group, respectively, using propensity score matching. No statistically significant difference in MPIS reduction (3.7 vs. 4.3;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.13) or the hospitalization rate (26.5% vs. 20.4%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.48) was found between the groups. The LOS (94 vs. 61\u2009min;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) was significantly shorter in the MDI group. Only one patient (2.0%) using an MDI experienced vomiting.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An MDI with a spacer was comparable to an NEB in effectiveness and was associated with a shorter LOS and lower incidence of adverse events. An MDI with a spacer may serve as an alternative to an NEB for administering inhaled procaterol in patients with acute asthma exacerbation in the PED.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70072","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T07:50:36Z","timestamp":1747209036000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Procaterol via nebulizer versus metered\u2010dose inhaler with a spacer for acute asthma exacerbation in children"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6500-6209","authenticated-orcid":false,"given":"Kenta","family":"Sugiura","sequence":"first","affiliation":[{"name":"Division of Pediatric Emergency Medicine Tokyo Metropolitan Children's Medical Center  Fuchu Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9677-6000","authenticated-orcid":false,"given":"Yusuke","family":"Hagiwara","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine Tokyo Metropolitan Children's Medical Center  Fuchu Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1296-1768","authenticated-orcid":false,"given":"Osamu","family":"Nomura","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine Tokyo Metropolitan Children's Medical Center  Fuchu Tokyo Japan"},{"name":"Medical Education Development Center Gifu University  Gifu Gifu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1437-0374","authenticated-orcid":false,"given":"Yoshihiko","family":"Morikawa","sequence":"additional","affiliation":[{"name":"Clinical Research Support Center Tokyo Metropolitan Children's Medical Center  Fuchu Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0241-6467","authenticated-orcid":false,"given":"Hiroshi","family":"Hataya","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics Tokyo Metropolitan Children's Medical Center  Fuchu Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5041-7408","authenticated-orcid":false,"given":"Koichi","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Division of Allergy Tokyo Metropolitan Children's Medical Center  Fuchu Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.4274\/jpr.galenos.2021.29577"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.5620\/eaht.2021027"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2012.02865.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2014.10.011"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.14437"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016\u20100088"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.alit.2020.02.005"},{"issue":"9","key":"e_1_2_9_9_1","article-title":"Holding chambers (spacers) versus nebulisers for beta\u2010agonist treatment of acute asthma","volume":"2013","author":"Cates CJ","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/emp2.12224"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-0496(200004)29:4<264::AID-PPUL5>3.0.CO;2-S"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.106.2.311"},{"key":"e_1_2_9_13_1","unstructured":"Global Initiative for Asthma.Global strategy for asthma management and prevention.2022."},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2020.106236"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/02770903.2016.1185114"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3388\/jspaci.31.326"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/ped.14146"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)60987-8"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.alit.2014.10.003"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.31662\/jmaj.2018-0010"},{"key":"e_1_2_9_21_1","unstructured":"U.S. Department of Health and Human Services.Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0.2017. 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