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The metered-dose inhaler with spacer (MDI) has been found to be at least as effective as the nebulizer for acute asthma in adults and older children, but there is insufficient evidence in children younger than 2 years. These researchers conducted a randomized, double-blind, placebo-controlled trial of albuterol delivered by MDI versus nebulizer in a convenience sample of acutely wheezing children aged 2 months to 2 years who were treated at a pediatric emergency department during an 18-month period.
Of 202 children screened, 168 met the study criteria. A single investigator treated all patients and determined the final disposition. Hospital admission rate was the main outcome measure. After controlling for wheezing severity using the Pulmona…