Comparison of Circulaire™ to Conventional Small Volume Nebulizer for the Treatment of Bronchospasm in the Emergency Department

Abstract

INTRODUCTION: The Circulaire™ (C-Neb), a hand-held small volume nebulizer, has been previously shown to have superior performance characteristics: greater peripheral lung deposition, reduced gastrointestinal system deposition, and reduced aerosol loss to the environment. This study evaluated whether the increased lung deposition would yield an improvement in pulmonary function without increasing extrapulmonary side effects. METHODS: All patients entering our Emergency Department with acute bronchospasm requiring aerosolized β-agonist therapy were randomized to either the C-Neb or the hospital's standard nebulizer. Patients were blinded to the purpose of the study. RESULTS: At 20 minutes post-treatment the C-Neb had a greater improvement in peak expiratory flow, heart rate, and respiratory rate compared to the standard nebulizer. There was no difference in blood pressure, tremulousness, and nausea. The C-Neb required less time to complete the aerosolization. CONCLUSION: The C-Neb had a superior clinical profile compared to the standard nebulizer for the initial treatment of patients with acute bronchospsm.