Comparison of Mesh Nebulizer and Compressor Nebulizer With Pulmonary Function Test in Pediatric Asthma Attacks
Condition: Asthma; Asthma in Children
MeSH terms: Asthma
Study type: Interventional

Summary: 
      Asthma is a worldwide health problem and is one of the most common chronic diseases of
      childhood in most countries. Symptoms begin before the age of 5 years in 80% of children with
      asthma, but the diagnosis is not always easy. The National Asthma Education and Prevention
      Program (NAEPP) expert panel recommends spirometry testing for children over 5 years of age.
      Spirometry measurements include forced vital capacity (FVC) and the forced expiratory volume
      in first second (FEV1). Airflow obstruction is defined as FEV1 reduced to less than 80
      percent predicted and an FEV1/FVC ratio of less than 0.85 (85 percent). Reference values are
      based on age, height, sex, and race. Forced expiratory flow between 25 and 75 percent of
      vital capacity (FEF25-75) less than 65 percent correlates with reversible airflow obstruction
      in children with normal FEV1 and may be a useful measure in this subgroup.

      In the spirometry test, FEV1, FVC, FEF 25-75% values are valuable for the follow-up of
      asthma. While the FEV1/FVC ratio is above 80% in healthy children, it may decrease below 75%
      in diseases such as asthma. Likewise, FEV1 and FEF can be found to be low in 50-75% of asthma
      patients. In addition, these values can be used to determine the effectiveness of the inhaler
      given with the nebulizer given during the attack. Spirometry should be performed before and
      after administration of a bronchodilator to assess for reversibility (bronchodilator response
      [BDR]) even in children with a normal baseline FEV1 because many of these children will still
      have a BDR (both within the normal range and sometimes also supranormal) after treatment.
      Significant reversibility is indicated by an increase in FEV1 of ≥12 percent from baseline
      after administration of a short-acting bronchodilator. This definition for BDR positivity was
      established primarily in adults. An increase in FEV1 of ≥8 percent may be a better definition
      for BDR in children.

      Inhaled short-acting beta-2 agonists, particularly albuterol (salbutamol), are the standard
      emergent treatment for acute asthma exacerbations in all patients based upon adult data. It
      is recommended to be given every 20 minutes in case of need for repeated doses in mild and
      moderate asthma attacks. Different types of nebulizers can be used for inhaler therapy; they
      can convert drugs into vapor form with sound waves, compressed air or by using electrical
      energy. While compressor nebulizers convert the liquid drug into aerosol form with compressed
      air, mesh nebulizers convert the drug into aerosol form with the vibrations they create with
      the help of electrical energy. Mesh nebulizers are more effective than other types of
      nebulizers, and the amount left in the chamber is less than other models, and it can
      decompose the drug into smaller particles and reach the more extreme branches of the lung.

      In our study, the investigators aimed to determine which nebulizer type is more effective by
      comparing the effects of mesh nebulizer and compressor nebulizer on spirometry test in
      children presenting with asthma attack. Thus, the investigators planned to find the most
      comfortable and effective method for patients by determining the appropriate nebulization
      technique for patients.
    


Intervention name(s): Group 1; Group 2
Intervention type(s): Device; Device
Intervention description(s): Salbutamol inhaler, Omron® CompAIR Pro NE-C900 Compressor Nebulizer (Omron Healthcare Co., Ltd., Kyoto, Japan) was used in Group 1; Salbutamol inhaler, Mesh nebulizer (Aerogen Solo®, Aerogen Ltd, Galway, Ireland) was used in Group 2
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Asthma; Child; Compressor Nebulizer; Mesh Nebulizer; Pulmonary function test