COMPARISON OF TWO INHALATIONAL TECHNIQUES FOR BRONCHODILATOR ADMINISTRATION IN CHILDREN AND ADOLESCENTS WITH ACUTE ASTHMA CRISIS: A META-ANALYSIS

ABSTRACT Objective: To compare the efficacy of pediatric asthma treatment by nebulizer and metered-dose inhaler with the use of a spacer (MDI-spacer) in rescue techniques for asthmatic patients assisted at pediatric emergency units. Data sources: A systematic review was conducted to identify the most relevant randomized controlled trials comparing the administration of a bronchodilator (β-2 agonist) by two inhalation techniques (nebulization and MDI-spacer) to treat asthma in children at pediatric emergency units. The following databases were searched: PubMed, Scientific Electronic Library Online (SciELO), and ScienceDirect. Two researchers independently applied the eligibility criteria, and only randomized controlled trials that compared both inhalation techniques (nebulization and MDI-spacer) for asthma treatment at pediatric emergency units were included. Data synthesis: 212 articles were pre-selected, of which only nine met the eligibility criteria and were included in meta-analysis. Results show no differences between inhalation techniques for any of the four outcomes analyzed: heart rate (difference - Df: 1.99 [95% confidence interval - 95%CI -2.01-6.00]); respiratory rate (Df: 0.11 [95%CI -1.35-1.56]); O2 saturation (Df: -0.01 [95%CI -0.50-0.48]); and asthma score (Df: 0.06 [95%CI -0,26-0.38]). Conclusions: The findings demonstrate no differences in cardiorespiratory frequency, O2 saturation, and asthma scores upon administration of β-2 agonist by both inhalation techniques (nebulization and MDI-spacer) to asthmatic patients assisted at pediatric emergency units.