Nebulized b2 adrenergic agonists are still the first line drugs for a rapid bronchodilatation & an easily adminstered drug during acute asthma attack. Purpose of this study is to assess theraputic response patterns of severe acute asthma patients to high and cumulative doses of salbutamol.
70 patients with sign symptoms of severe acute asthma (PEFR<50% but >30% of predicted), who were previously diagnosed and registered as suffering from bronchial asthma in Asthma Centre, NIDCH Dhaka were enrolled in this study. All patients were treated with salbutamol delivered with a metered dose inhaler into a spacer device in 4 puffs(400mg) at 10 min intervale for 2 hours. Variable were recorded at 0,30,60,90& 120 min & compared to each other for statistical significanse.
Among the 70 patients included in the study 53 (75.7%) achieved the discharge threshold(eg,PEFR>70%) after the end of 2 hours of treatment. 17 patients (24.3%) failed to reach the discharge threshold and 2(2.8%) of them can not complete the protocol treatment due to intolarable side effects. Analysis of the variables reveals statistically significant decrease in respiratory rate, use of accessory muscles, wheezing & dyspnoea. Heart rate was increased significantly but there were very little change in systolic & diastolic pressures. SaO2 increased significantly but the most significant improvement was noted in PEFR both in L/min and % predicted.
High and cumulative doses of salbutamol delivered through an MDI with spacer device is an effective, well tolerated modality of treatment for severe acut attack.
This effective low tech single drug treatment modality can be an option for treatment of severe acute asthma in emergency situation at home condition as well as during patient transport to hospital. As more then 75% patient responded well to this treatment it may reduce hospital admission in patients with severe acute asthma.
M. Rahman, None.