Late Breaking Abstract - Comparison of mesh and jet nebulizers with different interfaces in acute moderate to severe paediatric asthma

Abstract

Background: Mesh nebulizers (MN) combined with valved masks or mouthpieces have been shown to be more efficient and deliver higher concentrations of medication compared to jet nebulizers (JN) used with aerosol masks and mouthpieces. However, the clinical efficacy of delivering higher doses has not been established. The purpose of this study was to compare clinical outcomes related to using a MN versus JN in the treatment of pediatric patients with acute moderate to severe asthma exacerbations. Methods: We conducted a single-blinded RCT of 217 children (2-18 years old) with a known history of asthma who presented to the emergency department with an acute moderate to severe exacerbation. Severity was defined by our acute asthma score (AS). Patients were randomized to receive bronchodilator treatment via MN or standard JN and were treated per our acute asthma clinical pathway until they received a mild AS and discharge status or admit disposition. Results: 108 patients were randomized to receive bronchodilator treatment via MN and 109 via JN. The MN group required significantly less total albuterol [10.0 mg (5.0 - 15.0) vs 15.0 mg (10.0 - 25.0), p Conclusion: In Children with acute moderate to severe asthma exacerbations, use of MN with valved mask or mouthpiece was associated with a significant decrease in bronchodilator dose compared to JN, and in patients with mask interface, MN significantly reduced the probability of admission.