Background: The bronchodilator therapy is an essential component of the management of asthma exacertbation. The delivery of the bronchodilator to the lungs in asthma exacerbations is usually achieved through nebulizing the bronchodilator medications. The commonly used nebulizer device is a small volume jet nebulizer which has not been persistently reliable in delivering the bronchodilator therapy. Aeroneb nebulize device is a FDA approved device which produced consistently respirable sized particles which could potentially result in better bronchodilator effect.
Aim: To study whether Aeroneb nebulizer is more effective than small volume jet nebulizer in delivering bronchodilators in severe asthma exacerbation.
Experiment Design: Patients will be randomized (lie a flip of a coin) to receive the bronchodilator therapy as per the emergency room protocol either via small volume jet nebulizer or Aeroneb nebulizer.
Subjects: Adults patients between the age of 18 and 66 years who present to the emergency room with severe asthma exacerbation with peak respiratory flow rate <50% of predicted.
Study Procedure: When enrolled int he study and after randomization, we will then collect data that is standard for the hospital like heart rate, blood pressure and breathing indices and also some non-routine things like some scoring scales for shortness of breath and serial measurements of the peak expiratory flow rate.
- Acute asthma exacerbations presenting to the emergency room
- Peak expiratory flow rate at presentation< 50% of predicted
- Enrollment within 90 minutes of the arrival to the ER
- History of chronic obstructive pulmonary disease
- Clinical evidence of acute coronary syndrome
- Respiratory failure requiring mechanical ventilation either invasive or non-invasive
The study takes place during the ER visit and requires no further visits for research purposes. The clinical data as well as the peak flow measurement will be collected at the start of the study and at 30 minutes, 60 minutes and 180 minute intervals. There will be a post-enrollment phone interview with 1-2 weeks.