Dr T. Preethi Shahila, Dr G Sangamithra


Background: Effective management of Acute bronchial asthma may reduce the mortality and morbidity in adults which can be achieved by educating the patient with aerosol inhalation devices. Now a days salbutamol administration with metered- dose inhaler and spacer play a unique  role in treatment of acute asthma.
Objective: Our study analyse the efficacy of salbutamol administered by a nebuliser compared to metered-
dose inhaler and spacer in adults with Acute asthma.            
Materials and Methods: The study was conducted on 52 patients admitted in the Medical ward of tertiary care hospital. We categorised them into  two groups. Group I received salbutamol Via MDI with spacer and Group II received salbutamol via nebuliser. Approval from the hospital ethical committee was obtained. The study was a cohort study conducted for a period of 6 months  from May 2012 to October 2012.
Results : There is stastistically  significant  improvement  in PEFR ,  FEV1  and FVC  at 30 mts and at end of treatment with the MDI-Spacer group than with the nebulised group. There is no statistically significant difference between MDI-spacer  and nebuliser groups in the heart rate and respiratory rate at 30 minutes and at the end of treatment. Change in oxygen saturation at 30mts was 3.92±0.404 (MDI-Spacer) and 2.23±0.430 (nebulised group) .It was significant with p<0.001 at 30mts.At the end of treatment the corresponding values were 2.23±0.430(MDI-spacer) and 2.12± .33)(nebulised group). There was no  statistically significant difference (p 0.304). The requirement of salbutamol in MDI-spacer is  significantly lower than nebulizer as suggested by p value less than .001.We concluded there was no significant difference between the two groups, moreover MDI with spacer was better than nebuliser for the treatment of severe acute asthma attack in adults.
Conclusion: Our study supported and confirmed the evidence that MDI with spacer is as effective as nebuliser in the management of acute asthma.


MDI, spacer, Nebuliser, Salbutamol, inhaler .

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