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Continuous vs Intermittent ^-Agonists in the Treatment of Acute Adult Asthma:

No benefit was observed after 1 h of treatment (severe asthma subgroup: SMD, -0.20; 95% CI, -0.43 to 0.04; x2, 3.5; df, 4; p = 0.5; moderate asthma subgroup: SMD, -0.04; 95% CI, -0.40 to 0.33; x2, 0.4; df, 1; p = 0.5) and after 2 to 3 h of treatment (severe asthma subgroup: SMD, -4.32; 95% CI, -8.78 to 0.14; x2, 1.7; df, 4; p = 0.8; moderate asthma subgroup: SMD, 3.11; 95% CI, -10.2 to 16.4; x2, 1.38; df, 1; p = 0.3). Similarly, the methodological quality of the studies did not alter the results. Thus, there were no differences in pulmonary function between high-quality and low-quality trials after 1 h of treatment (high-quality trials: SMD, -3.5; 95% CI, -11.6 to 4.6; x2, 1.24; df, 1; p = 0.3; low-quality trials: SMD, -2.6; 95% CI, -7.3 to 1.9; x2, 3.59; df, 4; p = 0.5) and after 2 to 3 h of treatment (high-quality trials: SMD, -3.4; 95% CI, -12.0 to 5.3; x2, 0.89; df, 1; p = 0.4; low-quality trials: SMD, -3.6; 95% CI, -8.4 to 1.2; x2, 3.26; df, 4; p = 0.5). Finally, there was no apparent impact on pulmonary function when high doses or low doses of albuterol were used after 1 h of treatment (high doses: SMD, 0.0; 95% CI, -0.34 to 0.33; x2, 0.72; df, 2; p = 0.7; low doses: SMD, -0.14; 95% CI, -0.42 to 0.13; x2, 3.38; df, 3; p = 0.3) and after 2 to 3 h of treatment (high doses: SMD, -2.92; 95% CI, -8.94 to 3.11; x2, 0.86; df, 2; p = 0.6; low doses: SMD, -4.16; 95% CI, -10.1 to 1.81; x2, 3.17; df, 3; p = 0.5). asthma medications inhalers

The purpose of this systematic review is to determine whether continuous nebulization offered an advantage over intermittent nebulization for the treatment of adults with acute asthma in the ED. Our analysis failed to demonstrate statistically significant differences between groups in terms of pulmonary function or hospital admission rates. The intensity of treatment (ie, the albuterol dose) and the severity of the exacerbation did not influence the effect of either method of albuterol delivery.