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Reactive airway disease is a major source of morbidity in infants and children ages 2–24 months.1 Administering bronchodilators via nebulizer is expensive and can be difficult to achieve in a busy emergency department (ED) with a limited number of oxygen ports.2 Administration of bronchodilators by metered-dose inhaler (MDI) may be hampered by the younger patient’s inability to coordinate inspiration with activation of the MDI. Previous studies comparing nebulized bronchodilators with MDI have not used a double-blind, placebo-controlled design, have focused on drug delivery rather than clinical outcomes, have not compared the efficacy of an MDI with a spacer device to that of nebulizer, or have included sedated patients.
These authors from Albert Einstein College of Medicine in Bronx, New York, used a double-blind, randomized, placebo-controlled clinical …
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