Asthma Exacerbation, Emergency Department, Nebulization
Conditions
Keywords
asthma exacerbation, continuous nebulization, intermittent nebulization
Brief summary
The goal of this clinical is to compare treatment outcomes between continuous nebulization and intermittent therapy in the management of acute exacerbation of asthma in the emergency department(ED). Participants will random assign to either continuous or intermittent nebulization. In the continuous group, patients receive budesonide, fenoterol, ipratropium bromide, and normal saline continuously for an hour. In the intermittent group, the same medications are administer every 20 minutes for an hour. Measurements include symptom severity, respiratory rate, oxygen saturation, and pulmonary function tests. Primary endpoints are ED stay length, hospital admission, and ED revisit within 48 hours post-discharge. Adverse events are documented.
Interventions
DEVICEcontinuous nebulization
continuous nebulization using the MiniHEART-HiFlo® nebulizer containing Budesonide 1000 microgram/2 ml (3 respules) + 1.25 mg of fenoterol and 0.5 mg of ipratropium bromide (Berodual®, 4 ml) and Normal saline 12 ml in the nebulizer chamber. Patients in this group will receive continuous aerosol therapy over a period of 1 hour at an oxygen flow rate of 8 L/min
DEVICEIntermittent nebulization
intermittent nebulization using a nebulizer containing Budesonide 1000 microgram/2 ml (1 respules) + 1.25 mg of fenoterol and 0.5 mg of ipratropium bromide (Berodual®, 4 ml) at an oxygen flow rate of 10 L/min every 20 minutes, thrice within 1 hour
Sponsors
Thammasat University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
randomized controlled trial (RCT)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* asthma exacerbation
Exclusion criteria
* life-threatening conditions requiring intubation * allergy to steroid or its components * patient under investigation of Corona Virus Disease, 2019 (COVID-19) * pulmonary tuberculosis * unable to cooperate for pulmonary function testing
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Length of ED stay | through study completion, an average of 1 year | duration of ED management |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| pulmonary function test | through study completion, an average of 1 year | Forced Expiratory Volume in one second(FEV1), Peak Expiratory Flow(PEF) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Hospital admission | through study completion, an average of 1 year | — |
| ED revisit within 48 hours | through study completion, an average of 1 year | revisit with acute asthma exacerbation |
Contacts
Primary ContactKumpol Kornthatchapong, Assoc.Prof.
Outcome results
None listed