Chest
Clinical InvestigationsAsthmaContinuous vs Intermittent β-Agonists in the Treatment of Acute Adult Asthma: A Systematic Review With Meta-analysis
Section snippets
Literature Search and Selection of Studies
A computerized search was conducted to identify literature on the topic of continuous vs intermittent nebulization with β-agonists in adult patients with acute asthma. We searched for studies using the MEDLINE (1966 to 2001), EMBASE (1980 to 2001), and CINAHL (1982 to 2001) databases. The following MeSH terms were used in the search: Emerg* or acute or status and continuous or intermittent or multi-dose or dosage or nebuli* and β-agonist or bronchodilat*. Also, a search of the Cochrane
Results
Sixty-two articles were identified in the initial search. Of these, reviewers found that 16 articles were potentially eligible. Most of the others were excluded because they were not clinical trials of patients with acute asthma. The reasons for subsequent exclusion were nonrandomized trials (n = 6),356202122 only a continuous nebulization group included in the study (n = 1),23 only pediatric patients included in the study (n = 2),78 and non-acute asthma patients included in the study (n = 1).4
Discussion
The purpose of this systematic review is to determine whether continuous nebulization offered an advantage over intermittent nebulization for the treatment of adults with acute asthma in the ED. Our analysis failed to demonstrate statistically significant differences between groups in terms of pulmonary function or hospital admission rates. The intensity of treatment (ie, the albuterol dose) and the severity of the exacerbation did not influence the effect of either method of albuterol
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2022, Trauma Case ReportsCitation Excerpt :While our patient received a very high dose of albuterol, tachycardia did not worsen and improved with stabilization of the underlying physiology. However, much debate remains regarding a preference between continuous versus intermittent B2 agonists [5–8]. While acute settings may prompt physicians to administer variable doses and frequencies of albuterol, the overall goal in the management of severe acute asthma is the fastest delivery of medication to the most distal regions of the bronchial tree.
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