Background: The bronchodilator therapy is an essential component of the management of asthma
exacerbation. The delivery of bronchodilators to the lungs in asthma exacerbations is usually
achieved through nebulization (creating small particles to be inhaled). The commonly used
nebulizer device is a small volume jet nebulizer which has not been consistently reliable in
delivering bronchodilator therapy. The Aeroneb nebulizer device is a FDA approved device
which produces consistently respirable sized particles which could potentially result in
better bronchodilator effect than the standard jet nebulizer.
Aim: To study whether the Aeroneb nebulizer is more effective than a small volume jet
nebulizer in delivering bronchodilators during a severe asthma exacerbation.
Experimental design: Patients will be randomized (like a flip of a coin) to receive
bronchodilator therapy as per the emergency room protocol either via small volume jet
nebulizer or Aeroneb nebulizer.
Subjects: Adult patients between age of 18 and 55 years who present to the emergency room
with severe asthma exacerbation with peak expiratory flow rate <50% of predicted.
Study procedure: When enrolled in the study and after randomization, we will then collect
data that is standard for the hospital like heart rate, blood pressure and breathing indices
and also some non-routine things like some scoring scales for shortness of breath and serial
measurements of peak expiratory flow rate. We anticipate that the Aeroneb device will be more
effective in delivering bronchodilator medication and thus more effective in managing asthma