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2006;55:167-171
ORIGINAL ARTICLE
KEY WORDS
9300194, Japan.
Email: yadachi@med.u!toyama.ac.jp
Received 26 August 2005. Accepted for publication 1 December
2005.
!2006 Japanese Society of Allergology
INTRODUCTION
167
Adachi YS et al.
Tabl
e1 Demogr
aphyofpat
i
entpopul
at
i
on
R
eMot
i
on
Chi
l
dr
enaged
y
6
mi
l
dast
hmaat
t
ack
n
boy/
gi
r
l
Age(
y)
%FEV1.0
%PEFR
SpO2(
%)
HR(
bpm)
st
abl
est
at
e
n
boy/
gi
r
l
Age(
y)
St
ep1/2/3(
JPGL)
%FEV1.0
%PEFR
%V50
HR(
bpm)
Chi
l
dr
enaged
y
5
mi
l
dast
hmaat
t
ack
n
boy/
gi
r
l
Age(
y)
SpO2(
%)
HR(
bpm)
R
J
uni
orBOY
pv
al
ue
8
4/
4
8.
4 /
1.
8[
7 11]
68.
6 / 16.
9
89.
3 / 17.
5
95.
3 / 1.
3
109.
6 / 17.
7
9
5/
4
7.
4 /
1.
1[
6 10]
65.
3 / 8.
9
83.
2 / 24.
8
96.
1 / 1.
8
105.
9 / 19.
1
ns
ns
ns
ns
ns
ns
21
8/
13
8.
6 /
/
1.
7[
612]
8/7/6
94.
3 / 9.
0
120.
6 / 20.
1
71.
9 / 17.
6
89.
6 / 11.
5
18
9/
9
8.
6 /
1.
9[
6 13]
6/3/9
98.
1 / 14.
3
120.
8 / 27.
7
73.
2 / 25.
5
89.
0 / 13.
4
ns
ns
ns
ns
ns
ns
ns
8
6/
2
3.
3 /
1.
8[
0.
55]
96.
6 / 1.
1
128.
0 / 17.
7
9
5/
4
2.
9 / 1.
3[
1 5]
95.
4 / 2.
5
131.
4 / 17.
6
ns
ns
ns
ns
Dat
aar
eex
pr
es
s
edasmean SD[
r
ange]
,ns
;nots
i
gni
f
i
c
ant
J
PGL;J
apanes
epedi
at
r
i
cgui
del
i
nef
ort
het
r
eat
mentandmanagementofas
t
hma
SpO2;t
r
ans
c
ut
aneousox
y
gens
at
ur
at
i
on,HR;hear
tr
at
e
METHODS
To compare the usefulness and safety of eMotion!
( PARI , Starnberg , Germany ) with a conventional
nebulizer , Junior BOY! ( PARI ) , changes in lung
functions, transcutaneous oxygen saturation (SpO2)
levels and heart rates of 73 asthmatic children were
measured prior to and 15 minutes after beta2-agonist
inhalation. Children were also asked and examined
for the presence of any adverse symptoms such as
nausea, headaches, palpitations, and tremors. Inhalation of 1 g!
kg of procaterol (Otsuka Pharmaceutical,
Tokyo , Japan ) in 2 ml of disodium cromoglycate
168
**
**
RESULTS
120
%FEV1.0 (%)
100
80
60
40
20
0
pre
B
post
pre
160
post
**
140
%PEFR (%)
120
100
80
60
40
20
DISCUSSION
0
pre
C
post
pre
100
post
*
SpO2 (%)
98
96
94
92
90
0
pre
post
eMotion
pre
post
Junior BOY
Fi
g.1 Changesi
nl
ungf
unct
i
onandoxygensat
ur
at
i
onby
bet
a2agoni
sti
nhal
at
i
on i
n school
aged chi
l
dr
en wi
t
h mi
l
d
ast
hmaexacer
bat
i
on.Af
t
erbet
a2agoni
sti
nhal
at
i
onwi
t
ht
wo
di
f
f
er
entnebul
i
zer
s,FEV1.0 (
A)
,PEFR (
B)
,and SpO2 (
C)
wer
esi
gni
f
i
cant
l
yi
mpr
oved.*
;p 0.
05,*
*
;p 0.
01
169
Adachi YS et al.
B
160
160
140
120
100
140
120
100
80
80
0
0
pre
post
eMotion
pre
pre
post
Junior BOY
post
pre
eMotion
post
Junior BOY
Fi
g.2 Changesi
nhear
tr
at
esi
nc
hi
l
dr
enwi
t
hmi
l
das
t
hmaex
ac
er
bat
i
on.Nos
i
gni
f
i
c
ant
changeswer
ef
oundi
nhear
tr
at
esaf
t
erbet
a2agoni
s
ti
nhal
at
i
oni
nei
t
hers
c
hool
agedc
hi
l
dr
en(
A)oryoungerchi
l
dr
en(
B)
.
Tabl
e2 Ef
f
ectofbet
a2agoni
sti
nhal
at
i
onf
orast
hmat
i
cc
hi
l
dr
eni
ns
t
abl
ec
ondi
t
i
on
R
eMot
i
on
pr
e
%FEV1.0
%PEFR
.
%V50
HR(
bpm)
R
J
uni
orBOY
post
pv
al
ue
94.
3 / 9.
0
120.
6 / 20.
1
71.
9 / 17.
6
105.
0 / 10.
9
135.
1 / 21.
2
94.
4 / 17.
0
0.
001
0.
01
0.
001
89.
6 / 11.
5
90.
4 / 11.
8
ns
pr
e
pos
t
98.
1 / 14.
3 106.
3 / 15.
0
120.
8 / 27.
7 129.
6 / 30.
0
73.
2 / 25.
5 92.
5 / 26.
7
89.
0 / 13.
4
91.
7 / 12.
0
pval
ue
0.
001
0.
05
0.
001
ns
HR;hear
tr
at
e,ns
;nots
i
gni
f
i
c
ant
170
mean percent increase in heart rate after beta 2agonist inhalation ( 15% vs 5% ) . Kerem et al. also
showed similar results, 8 and the Cochrane systemic
review reported that the MDI plus spacer may have
advantages compared to nebulizers for children with
acute asthma because of the lower heart rate for spacers. 2 In the present study, no adverse effects including significant increases of heart rate were found in
children using both nebulizers. The dose of beta 2agonists used in this study was lower compared to
that used in the emergency setting, where inhalation
of higher doses of beta 2-agonists are usually performed 2 to 3 times in the first one hour. Although no
controlled study has been undertaken to determine
the optimal dose of beta2-agonists for the treatment
of children with acute asthma attacks, at least the present study showed that eMotion! is safe at the ordinary dose of beta2-agonists. However, further studies
will be necessary when eMotion! is used for inhalation of budesonide nebulizing suspensions, because
the adverse effects of inhaled steroid is related to the
accumulating dose.
In conclusion , a new electronic mesh nebulizer ,
eMotion! is clinically safe and effective when it is
used for administration of beta2-agonists to children
with asthma. The shorter inhalation time may be a
contributing factor for the favorable acceptance and
REFERENCES
171