{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T12:14:32Z","timestamp":1789820072350,"version":"4.0.1"},"reference-count":20,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,8,1]]},"abstract":"<jats:p>Inhaled albuterol is the most frequently used bronchodilator for acute wheezing, and nebulization is the standard mode of delivery in hospital setting. However, recent guidelines consider spacer devices as an easier to use, and cost-saving alternative and recommend the high-dose metered-dose inhaler bronchodilator.<\/jats:p>\n               <jats:p>Objective.\u2003To demonstrate clinical equivalence between a spacer device and a nebulizer for albuterol administration.<\/jats:p>\n               <jats:p>Design.\u2003Randomized, double-blind, parallel group equivalence trial.<\/jats:p>\n               <jats:p>Setting.\u2003Pediatric emergency wards at 2 tertiary teaching hospitals.<\/jats:p>\n               <jats:p>Patients.\u2003Sixty-four 12- to 60-month-old children with acute recurrent wheezing (32 per group).<\/jats:p>\n               <jats:p>Interventions.\u2003Albuterol was administered through the spacer device (50 \u03bcg\/kg) or through the nebulizer (150 \u03bcg\/kg) and repeated 3 times at 20-minute intervals. Parents completed a questionnaire.<\/jats:p>\n               <jats:p>Outcome Measures.\u2003Pulmonary index, hospitalization, ease of use, acceptability, and pulse oximetry saturation.<\/jats:p>\n               <jats:p>Results.\u2003The 90% confidence interval of the difference between treatment groups for the median absolute changes in pulmonary index values between T0 and T60 was [\u22121; +1] and was included in the equivalence interval [\u22121.5; +1.5]. Clinical improvement increased with time. Less than 10% of the children (3 in each group) required hospitalization (2 in each group attributable to treatment failure). Parents considered administration of albuterol using the spacer device easier (94%) and better accepted by their children (62%).<\/jats:p>\n               <jats:p>Conclusions.\u2003The efficacy of albuterol administered using the spacer device was equivalent to that of the nebulizer. Given its high tolerance, repeated 50-\u03bcg\/kg doses of albuterol administered through the spacer device should be considered in hospital emergency departments as first-line therapy for wheezing.<\/jats:p>","DOI":"10.1542\/peds.106.2.311","type":"journal-article","created":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T20:06:30Z","timestamp":1509566790000},"page":"311-317","source":"Crossref","is-referenced-by-count":64,"title":["High-Dose Albuterol by Metered-Dose Inhaler Plus a Spacer Device Versus Nebulization in Preschool Children With Recurrent Wheezing:  A Double-Blind, Randomized Equivalence Trial"],"prefix":"10.1542","volume":"106","author":[{"given":"Dominique","family":"Ploin","sequence":"first","affiliation":[{"name":"From the Service d'Urgence et de Re\u0301animation Pe\u0301diatrique, Ho\u0302pital Edouard Herriot, Hospices Civils, Lyon, France;"},{"name":"Unite\u0301 d'Accueil des Urgences Pe\u0301diatriques, Ho\u0302pital Debrousse, Hospices Civils, Lyon, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franc\u0327ois R.","family":"Chapuis","sequence":"additional","affiliation":[{"name":"Unite\u0301 de Recherche Clinique, De\u0301partement d'Information Me\u0301dicale, Hospices Civils, Lyon, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Stamm","sequence":"additional","affiliation":[{"name":"From the Service d'Urgence et de Re\u0301animation Pe\u0301diatrique, Ho\u0302pital Edouard Herriot, Hospices Civils, Lyon, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"Robert","sequence":"additional","affiliation":[{"name":"63 Bis rue de la Re\u0301publique, F-69150 De\u0301cines Charpieu, France;"},{"name":"De\u0301partement de Pe\u0301diatrie, Ho\u0302pital Edouard Herriot, Hospices Civils, Lyon, France; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"David","sequence":"additional","affiliation":[{"name":"De\u0301partement de Pe\u0301diatrie, Ho\u0302pital Edouard Herriot, Hospices Civils, Lyon, France; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre G.","family":"Chatelain","sequence":"additional","affiliation":[{"name":"Unite\u0301 d'Accueil des Urgences Pe\u0301diatriques, Ho\u0302pital Debrousse, Hospices Civils, Lyon, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Dutau","sequence":"additional","affiliation":[{"name":"Service de Pneumologie-Allergologie Pe\u0301diatrique, Ho\u0302pital des Enfants, Toulouse, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Floret","sequence":"additional","affiliation":[{"name":"From the Service d'Urgence et de Re\u0301animation Pe\u0301diatrique, Ho\u0302pital Edouard Herriot, Hospices Civils, Lyon, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2000,8,1]]},"reference":[{"key":"2021121003171072900_B1","doi-asserted-by":"crossref","first-page":"1522","DOI":"10.1136\/bmj.310.6993.1522","article-title":"[ABC of asthma] Asthma in children: treatment.","volume":"310","author":"Rees","year":"1995","journal-title":"Br Med J."},{"key":"2021121003171072900_B2","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/S0140-6736(97)90032-5","article-title":"Treatment of acute asthma.","volume":"350","author":"Lipworth","year":"1997","journal-title":"Lancet."},{"key":"2021121003171072900_B3","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1111\/j.1440-1754.1993.tb00459.x","article-title":"Consensus view. 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