Comparison of Nebulizers in ED in Pediatric Asthma Patients

Sponsor
Seton Healthcare Family (Other)
Overall Status
Terminated
CT.gov ID
NCT01951378
Collaborator
(none)
40
1
2
34
1.2

Study Details

Study Description

Brief Summary

The primary objective will be, in an open-label randomized trial, a comparison of emergency department (ED) length of stay (LOS) between children experiencing acute asthma treated with two different nebulizers. Secondary outcomes will include admission rates, hospital LOS, need for additional therapies, transfers to a higher level of care, side-effects, and unscheduled return visits

Condition or Disease Intervention/Treatment Phase
  • Device: Hudson RCI® nebulizer
  • Device: NebuTech® HDN® nebulizer
  • Drug: Albuterol
Phase 4

Detailed Description

To our knowledge, no study has compared a breath-enhanced nebulizer to a standard jet nebulizer for the treatment of acute asthma in children. The goal of this study is to determine whether a rapid albuterol delivery pathway with a breath-enhanced nebulizer can reduce ED LOS, while maintaining admission rates, repeat visits, adjunctive therapies, and side-effects, when compared to a traditional asthma pathway with a standard jet nebulizer. The Salter® Nebutech® HDN® was chosen because its breath-enhanced design and bolus delivery system may deliver greater amounts of albuterol to the small airways, in a shorter period of time, when compared with standard jet nebulizers and other nebulizers in its class.

The study site will be a large, urban pediatric emergency department (ED) with approximately 80,000 visits per year. The study protocol will be submitted to the hospital's Institutional Review Board (IRB) for approval. Children will be eligible for enrolment if they are between 3 and 18 years of age and present to the ED with an acute asthma exacerbation of at least moderate severity. The lower age cutoff was chosen because asthma diagnosis and beta agonist response can be unreliable in younger children. The upper age cutoff was chosen to include only pediatric patients, as this is a pediatric asthma study. Children must have a history of physician-diagnosed asthma as reported by the parent or guardian. Children will be enrolled when a research team member is available to obtain informed consent (convenience sample). Children will be excluded from enrollment if the initial pediatric asthma score (PAS) is < 3, immediate resuscitation is required, they have a history of chronic lung disease or congenital heart disease, they have any neuromuscular disease, intrathoracic foreign body is suspected, they are or may be pregnant, they are currently breast feeding, they have received oral or parenteral steroids within the last week (inhaled steroids are allowed), or they have an allergy or other contraindication to one of the study medications.

Potential subjects will be identified in triage and screened for enrolment if study personnel are available. If consented, the patient will be randomized to one of the two treatment arms. If there will be greater than a 15 minute delay in treatment due to the consent process, unit dose (2.5 mg) albuterol treatments will be given with a standard nebulizer up to 3 times as needed. That patient may still be enrolled provided he/she still meets inclusion/exclusion criteria.

Study Design

Study Type:
Interventional
Actual Enrollment :
40 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Supportive Care
Official Title:
Comparison of a Breath Enhanced High Density Jet Nebulizer With a Standard Jet Nebulizer for the Treatment of Children With a Moderate to Severe Asthma Exacerbation in the Emergency Department
Study Start Date :
Sep 1, 2013
Actual Primary Completion Date :
Jun 1, 2016
Actual Study Completion Date :
Jul 1, 2016

Arms and Interventions

Arm Intervention/Treatment
Active Comparator: Hudson RCI® nebulizer

Patients randomized to the "standard" arm will receive treatments as dictated by our standard ED asthma pathway (Fig. 1). All treatments will be administered with our standard ED nebulizer, the Hudson RCI® Up-Draft® Neb-U-Mist® nebulizer (Teleflex Medical®, Research Triangle Park, NJ), and a simple mask (Hudson RCI®, Teleflex Medical®, Research Triangle Park, NJ).

Device: Hudson RCI® nebulizer
After the first hour of treatment, patients in the standard arm will receive a repeat assessment, including all of the measurements collected at baseline as well as reported side effects. Those patients who score PAS 0-2 will then be discharged home, after an optional observation period, as per the pathway. Those who score PAS > 2 will receive a second treatment. At the end of the second treatment patients will again be re-assessed, and repeat measurements obtained. At that time, depending on the patient's PAS score, he/she will be dispositioned to home, the floor, the pulmonary high acuity unit (PHAU), or the pediatric intensive care unit (PICU).

Drug: Albuterol
Subjects may have started treatment prior to consent and may receives unit dose (2.5 mg) Albuterol/Proventil treatments will be given with a standard nebulizer up to 3 times as needed and may change over to study randomized device once consented to eith arm.
Other Names:
  • Proventil
  • Active Comparator: NebuTech® HDN® nebulizer

    Patients randomized to the "NebuTech®" arm will receive treatments as dictated by our trial pathway, referred to as the "rapid Albuterol/Proventil delivery pathway" (Fig. 2). All nebulizations in this arm will be administered via the Breath-Enhanced High Density Jet Nebulizer, NebuTech® HighDensityNebulizer®,(Salter Labs®, Arvin, CA). Respiratory Therapists (RT) will attempt to deliver all treatments with a mouthpiece, as that has been shown to be the most efficient and reliable mode of aerosol delivery for most children 31, 32. If the Respiratory Therapist feels that the child will not or cannot effectively use a mouthpiece, a mask will be used.

    Device: NebuTech® HDN® nebulizer
    All treatments in the NebuTech® arm will be given at a standard dilution of 5 ml (diluted with normal saline to a total volume of 5 ml as per the manufacturer's recommendation). Patients in this arm will receive up to four treatments with parameters measured after each treatment, similar to the control arm. Patients who complete four treatments will then be dispositioned based on PAS score, similar to the control arm. Subjects may have started treatment prior to consent and may receives unit dose (2.5 mg) Albuterol/Proventil treatments will be given with a standard nebulizer up to 3 times as needed and may change over to study randomized device once consented to eith arm.

    Drug: Albuterol
    Subjects may have started treatment prior to consent and may receives unit dose (2.5 mg) Albuterol/Proventil treatments will be given with a standard nebulizer up to 3 times as needed and may change over to study randomized device once consented to eith arm.
    Other Names:
  • Proventil
  • Outcome Measures

    Primary Outcome Measures

    1. The Primary Objective Will be, in an Open-label Randomized Trial, a Comparison of Emergency Department (ED) Length of Stay (LOS) Between Children Experiencing Acute Asthma Treated With Two Different Nebulizers [1 year]

      The primary endpoint will be mean ED LOS difference between the groups. Using historical data as a guide, we calculated a baseline LOS mean for discharged patients of 181 minutes, and standard deviation (SD) of 83 minutes. For this reason, an interim analysis will be conducted in order to assess a pilot sample for the purpose of estimating these values. 25 subjects in each arm (50 subjects total) will be enrolled during the initial phase of the study. This early phase interim analysis is not powered to test for differences between the groups, but establish pilot-phase findings that can be used for more accurate sample size calculation. However, the primary outcome of ED LOS will then be tested to determine the difference between study arms, using the non-parametric Mann-Whitney U test due to the likely skewed-nature of the distribution of ED LOS values for the purpose of establishing an estimate of effect size in the initial enrollment phase.

    Secondary Outcome Measures

    1. to Evaluate Admission Rates. [1 year]

      Baseline characteristics (demographics, history, and clinical characteristics of presentation) of subjects in each treatment arm will be summarized in a table. These descriptive characteristics will be compared between arms using standard t-test or a non-parametric alternative for linear values (eg, age) and chi-squared tests for binomial or categorical values (eg, gender) with p-values reported in the summary table.

    Other Outcome Measures

    1. Will Evaluate Hospital LOS. Safety Issue?: (FDAAA) No [1 year]

      Baseline characteristics (demographics, history, and clinical characteristics of presentation) of subjects in each treatment arm will be summarized in a table. These descriptive characteristics will be compared between arms using standard t-test or a non-parametric alternative for linear values (eg, age) and chi-squared tests for binomial or categorical values (eg, gender) with p-values reported in the summary table.

    2. Will Evaluate Need for Additional Therapies. [1 year]

      Baseline characteristics (demographics, history, and clinical characteristics of presentation) of subjects in each treatment arm will be summarized in a table. These descriptive characteristics will be compared between arms using standard t-test or a non-parametric alternative for linear values (eg, age) and chi-squared tests for binomial or categorical values (eg, gender) with p-values reported in the summary table.

    3. Will Evaluate Transfers to a Higher Level of Care. [1 year]

      Baseline characteristics (demographics, history, and clinical characteristics of presentation) of subjects in each treatment arm will be summarized in a table. These descriptive characteristics will be compared between arms using standard t-test or a non-parametric alternative for linear values (eg, age) and chi-squared tests for binomial or categorical values (eg, gender) with p-values reported in the summary table

    4. Will Evaluate for Unscheduled Return Visits. [1 year]

      Baseline characteristics (demographics, history, and clinical characteristics of presentation) of subjects in each treatment arm will be summarized in a table. These descriptive characteristics will be compared between arms using standard t-test or a non-parametric alternative for linear values (eg, age) and chi-squared tests for binomial or categorical values (eg, gender) with p-values reported in the summary table.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    3 Years to 17 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • Age ≥ 3 years and < 18 years

    • History of physician-diagnosed asthma

    • Presenting to ED with acute asthma exacerbation according to attending physician

    Exclusion Criteria:
    • PAS score < 3

    • Immediate resuscitation required

    • Chronic lung disease (other than asthma)

    • Congenital heart disease 5. Neuromuscular disease 6. Suspected intrathoracic foreign body 7. Is or may be pregnant 8. Currently breast feeding 9. Oral or parenteral steroids within the last 7 days 10. Allergy or other contraindication to any of the study medications

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Dell Children's Medical Center of Central Texas Austin Texas United States 78723

    Sponsors and Collaborators

    • Seton Healthcare Family

    Investigators

    • Principal Investigator: Matthew H. Wilkinson, MD, Seton Healthcare Family

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Seton Healthcare Family
    ClinicalTrials.gov Identifier:
    NCT01951378
    Other Study ID Numbers:
    • CR-13-119
    First Posted:
    Sep 26, 2013
    Last Update Posted:
    Apr 8, 2021
    Last Verified:
    Aug 1, 2020
    Individual Participant Data (IPD) Sharing Statement:
    No
    Plan to Share IPD:
    No
    Keywords provided by Seton Healthcare Family
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details
    Pre-assignment Detail
    Arm/Group Title Hudson RCI® Nebulizer NebuTech® HDN® Nebulizer
    Arm/Group Description Patients randomized to the standard arm will receive treatments as dictated by our standard ED asthma pathway (Fig. 1). All treatments will be administered with our standard ED nebulizer, the Hudson RCI® Up-Draft® Neb-U-Mist® nebulizer (Teleflex Medical®, Research Triangle Park, NJ), and a simple mask (Hudson RCI®, Teleflex Medical®, Research Triangle Park, NJ). Hudson RCI® nebulizer: After the first hour of treatment, patients in the standard arm will receive a repeat assessment, including all of the measurements collected at baseline as well as reported side effects. Those patients who score PAS 0-2 will then be discharged home, after an optional observation period, as per the pathway. Those who score PAS > 2 will receive a second treatment. At the end of the second treatment patients will again be re-assessed, and repeat measurements obtained. At that time, depending on the patient's PAS score, he/she will be dispositioned to home, the floor, the pulmonary high acuity unit (PHA Patients randomized to the NebuTech® arm will receive treatments as dictated by our trial pathway, referred to as the "rapid Albuterol/Proventil delivery pathway" (Fig. 2). All nebulizations in this arm will be administered via the Breath-Enhanced High Density Jet Nebulizer, NebuTech® HighDensityNebulizer®,(Salter Labs®, Arvin, CA). Respiratory Therapists (RT) will attempt to deliver all treatments with a mouthpiece, as that has been shown to be the most efficient and reliable mode of aerosol delivery for most children 31, 32. If the Respiratory Therapist feels that the child will not or cannot effectively use a mouthpiece, a mask will be used. NebuTech® HDN® nebulizer: All treatments in the NebuTech® arm will be given at a standard dilution of 5 ml (diluted with normal saline to a total volume of 5 ml as per the manufacturer's recommendation). Patients in this arm will receive up to four treatments with parameters measured after each treatment, similar to the control arm. Patient
    Period Title: Overall Study
    STARTED 23 17
    COMPLETED 0 0
    NOT COMPLETED 23 17

    Baseline Characteristics

    Arm/Group Title Hudson RCI® Nebulizer NebuTech® HDN® Nebulizer Total
    Arm/Group Description Patients randomized to standard arm receives treatments per standard ED asthma pathway. Treatments administered with standard ED nebulizer, Hudson RCI® Up-Draft® Neb-U-Mist® nebulizer (Teleflex Medical®, Research Triangle Park, NJ), and a simple mask (Hudson RCI®, Teleflex Medical®, Research Triangle Park, NJ). Hudson RCI® nebulizer: After 1 hour, patients in standard arm receive another assessment, with all baseline measurements and reported side effects. Patients who score PAS 0-2 will be discharged, after optional observation period, per pathway. Those who score PAS > 2 receive second treatment, then re-assessed, and measurements repeated. Then, depending on PAS score, he/she will be sent, the floor, the pulmonary high acuity unit (PHAU), or PICU. Albuterol: Subjects may begin treatment before consent and may receive 2.5 mg Albuterol/Proventil treatments given with standard nebulizer <3 times as needed and may change over to study randomized device once consented to either arm. Randomized patients receive treatments per "rapid Albuterol/Proventil delivery pathway". Nebulizations given via Breath-Enhanced High Density Jet Nebulizer, NebuTech® HighDensityNebulizer®,(Salter Labs®, Arvin, CA). If child will not or cannot use mouthpiece, a mask will be used. NebuTech® HDN® nebulizer: Treatments are dilution of 5 ml. Patients receive <4 treatments with measurements after each. Patients who complete 4 treatments will be dispositioned based on PAS score. Subjects may begin treatment before consent and may receive 2.5 mg Albuterol/Proventil treatments via standard nebulizer <3 times as needed and may change to study randomized device once consented to either arm. Albuterol: Subjects may start treatment before consent and may receives 2.5 mg Albuterol/Proventil given with standard nebulizer <3 times as needed and may change over to study randomized device once consented to either arm. Total of all reporting groups
    Overall Participants 23 17 40
    Age (Count of Participants)
    <=18 years
    23
    100%
    17
    100%
    40
    100%
    Between 18 and 65 years
    0
    0%
    0
    0%
    0
    0%
    >=65 years
    0
    0%
    0
    0%
    0
    0%
    Age (years) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [years]
    11
    (5)
    9
    (5)
    10
    (5)
    Sex: Female, Male (Count of Participants)
    Female
    10
    43.5%
    6
    35.3%
    16
    40%
    Male
    13
    56.5%
    11
    64.7%
    24
    60%
    Region of Enrollment (participants) [Number]
    United States
    23
    100%
    17
    100%
    40
    100%

    Outcome Measures

    1. Primary Outcome
    Title The Primary Objective Will be, in an Open-label Randomized Trial, a Comparison of Emergency Department (ED) Length of Stay (LOS) Between Children Experiencing Acute Asthma Treated With Two Different Nebulizers
    Description The primary endpoint will be mean ED LOS difference between the groups. Using historical data as a guide, we calculated a baseline LOS mean for discharged patients of 181 minutes, and standard deviation (SD) of 83 minutes. For this reason, an interim analysis will be conducted in order to assess a pilot sample for the purpose of estimating these values. 25 subjects in each arm (50 subjects total) will be enrolled during the initial phase of the study. This early phase interim analysis is not powered to test for differences between the groups, but establish pilot-phase findings that can be used for more accurate sample size calculation. However, the primary outcome of ED LOS will then be tested to determine the difference between study arms, using the non-parametric Mann-Whitney U test due to the likely skewed-nature of the distribution of ED LOS values for the purpose of establishing an estimate of effect size in the initial enrollment phase.
    Time Frame 1 year

    Outcome Measure Data

    Analysis Population Description
    No data are available for this study as the PI has left the institution and no study team member is present. The local IRB closed and was replaced in July 2017 by the University of Texas. Sincere efforts were made to obtain the data for reporting, however, no data are available
    Arm/Group Title Hudson RCI® Nebulizer NebuTech® HDN® Nebulizer
    Arm/Group Description Patients randomized to "standard" arm receives treatments by standard ED asthma pathway. Treatments administered with standard ED nebulizer, Hudson RCI® Up-Draft® Neb-U-Mist® nebulizer (Teleflex Medical®, Research Triangle Park, NJ), and simple mask (Hudson RCI®, Teleflex Medical®, Research Triangle Park, NJ). Hudson RCI® nebulizer: After 1 hour, patients in standard arm have repeat assessment, with all measurements collected at baseline and reported side effects. Patients who score PAS 0-2 will be discharged after observation, per pathway. Those who score PAS > 2 receive second treatment. After second treatment patients re-assessed, and repeat measurements obtained. Then, based on score, he/she will be dispositioned home, the floor, pulmonary high acuity unit (PHAU), or (PICU). Albuterol: Subjects may have treatment before consent and may receive 2.5 mg treatments with standard nebulizer up to 3 times as needed and may change to randomized device once consented to either arm. Patients randomized to "NebuTech®" arm receive treatments by, "rapid Albuterol/Proventil delivery pathway", given by Breath-Enhanced High Density Jet Nebulizer, NebuTech® HighDensityNebulizer®,(Salter Labs®, Arvin, CA). Respiratory Therapists (RT) will try to give treatments with mouthpiece, shown most efficient and reliable mode of aerosol delivery for children. If RT feels child will not or cannot use a mouthpiece, a mask will be used. NebuTech® HDN® nebulizer: Treatments given at 5 ml (diluted with normal saline). Patients complete <4 treatments, dispositioned based on PAS. Subjects may start treatment before consent and may receive 2.5 mg Albuterol/Proventil treatments given with standard nebulizer <3 times as needed and may change to study randomized device once consented. Albuterol: Subjects start treatment before consent and may receive 2.5 mg. Treatments receive standard nebulizer up to 3 times as needed and may change to randomized device once consented to either arm.
    Measure Participants 0 0
    2. Secondary Outcome
    Title to Evaluate Admission Rates.
    Description Baseline characteristics (demographics, history, and clinical characteristics of presentation) of subjects in each treatment arm will be summarized in a table. These descriptive characteristics will be compared between arms using standard t-test or a non-parametric alternative for linear values (eg, age) and chi-squared tests for binomial or categorical values (eg, gender) with p-values reported in the summary table.
    Time Frame 1 year

    Outcome Measure Data

    Analysis Population Description
    No data are available for this study as the PI has left the institution and no study team member is present. The local IRB closed and was replaced in July 2017 by the University of Texas. Sincere efforts were made to obtain the data for reporting, however, no data are available
    Arm/Group Title Hudson RCI® Nebulizer NebuTech® HDN® Nebulizer
    Arm/Group Description Patients randomized to "standard" arm receives treatments by standard ED asthma pathway. Treatments administered with standard ED nebulizer, Hudson RCI® Up-Draft® Neb-U-Mist® nebulizer (Teleflex Medical®, Research Triangle Park, NJ), and simple mask (Hudson RCI®, Teleflex Medical®, Research Triangle Park, NJ). Hudson RCI® nebulizer: After 1 hour, patients in standard arm have repeat assessment, with all measurements collected at baseline and reported side effects. Patients who score PAS 0-2 will be discharged after observation, per pathway. Those who score PAS > 2 receive second treatment. After second treatment patients re-assessed, and repeat measurements obtained. Then, based on score, he/she will be dispositioned home, the floor, pulmonary high acuity unit (PHAU), or (PICU). Albuterol: Subjects may have treatment before consent and may receive 2.5 mg treatments with standard nebulizer up to 3 times as needed and may change to randomized device once consented to either arm. Patients randomized to "NebuTech®" arm receive treatments by, "rapid Albuterol/Proventil delivery pathway", given by Breath-Enhanced High Density Jet Nebulizer, NebuTech® HighDensityNebulizer®,(Salter Labs®, Arvin, CA). Respiratory Therapists (RT) will try to give treatments with mouthpiece, shown most efficient and reliable mode of aerosol delivery for children. If RT feels child will not or cannot use a mouthpiece, a mask will be used. NebuTech® HDN® nebulizer: Treatments given at 5 ml (diluted with normal saline). Patients complete <4 treatments, dispositioned based on PAS. Subjects may start treatment before consent and may receive 2.5 mg Albuterol/Proventil treatments given with standard nebulizer <3 times as needed and may change to study randomized device once consented. Albuterol: Subjects start treatment before consent and may receive 2.5 mg. Treatments receive standard nebulizer up to 3 times as needed and may change to randomized device once consented to either arm.
    Measure Participants 0 0
    3. Other Pre-specified Outcome
    Title Will Evaluate Hospital LOS. Safety Issue?: (FDAAA) No
    Description Baseline characteristics (demographics, history, and clinical characteristics of presentation) of subjects in each treatment arm will be summarized in a table. These descriptive characteristics will be compared between arms using standard t-test or a non-parametric alternative for linear values (eg, age) and chi-squared tests for binomial or categorical values (eg, gender) with p-values reported in the summary table.
    Time Frame 1 year

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title
    Arm/Group Description
    4. Other Pre-specified Outcome
    Title Will Evaluate Need for Additional Therapies.
    Description Baseline characteristics (demographics, history, and clinical characteristics of presentation) of subjects in each treatment arm will be summarized in a table. These descriptive characteristics will be compared between arms using standard t-test or a non-parametric alternative for linear values (eg, age) and chi-squared tests for binomial or categorical values (eg, gender) with p-values reported in the summary table.
    Time Frame 1 year

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title
    Arm/Group Description
    5. Other Pre-specified Outcome
    Title Will Evaluate Transfers to a Higher Level of Care.
    Description Baseline characteristics (demographics, history, and clinical characteristics of presentation) of subjects in each treatment arm will be summarized in a table. These descriptive characteristics will be compared between arms using standard t-test or a non-parametric alternative for linear values (eg, age) and chi-squared tests for binomial or categorical values (eg, gender) with p-values reported in the summary table
    Time Frame 1 year

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title
    Arm/Group Description
    6. Other Pre-specified Outcome
    Title Will Evaluate for Unscheduled Return Visits.
    Description Baseline characteristics (demographics, history, and clinical characteristics of presentation) of subjects in each treatment arm will be summarized in a table. These descriptive characteristics will be compared between arms using standard t-test or a non-parametric alternative for linear values (eg, age) and chi-squared tests for binomial or categorical values (eg, gender) with p-values reported in the summary table.
    Time Frame 1 year

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title
    Arm/Group Description

    Adverse Events

    Time Frame No data are available for this study as the PI has left the institution and no study team member is present. The local IRB closed and was replaced in July 2017 by the University of Texas. Sincere efforts were made to obtain the data for reporting, however, no data are available
    Adverse Event Reporting Description No data are available for this study as the PI has left the institution and no study team member is present. The local IRB closed and was replaced in July 2017 by the University of Texas. Sincere efforts were made to obtain the data for reporting, however, no data are available
    Arm/Group Title Hudson RCI® Nebulizer NebuTech® HDN® Nebulizer
    Arm/Group Description Patients randomized to standard arm receive treatments by standard ED asthma pathway. Treatments administered with standard ED nebulizer, the Hudson RCI® Up-Draft® Neb-U-Mist® nebulizer (Teleflex Medical®, Research Triangle Park, NJ), and a simple mask (Hudson RCI®, Teleflex Medical®, Research Triangle Park, NJ). Hudson RCI® nebulizer: After 1 hour, patients in standard arm receive repeat assessment, including baseline measurements and reported side effects. Patients who score PAS 0-2 sent home, after optional observation period, per pathway. Those with score PAS > 2 receive second treatment, re-assessed, and repeat measurements. Based on patient's PAS score, he/she will be dispositioned home, the floor, the pulmonary high acuity unit (PHAU), or the pediatric intensive care unit (PICU). Albuterol: Subjects may start treatment before consent and receive 2.5 mg. Albuterol/Proventil treatments by standard nebulizer <3 times as needed and may change to study randomized device once c Patients randomized to "NebuTech®" arm will receive treatments as dictated by our trial pathway, referred to as the "rapid Albuterol/Proventil delivery pathway" (Fig. 2). All nebulizations in this arm will be administered via the Breath-Enhanced High Density Jet Nebulizer, NebuTech® HighDensityNebulizer®,(Salter Labs®, Arvin, CA). Respiratory Therapists (RT) will attempt to deliver all treatments with a mouthpiece, as that has been shown to be the most efficient and reliable mode of aerosol delivery for most children 31, 32. If the Respiratory Therapist feels that the child will not or cannot effectively use a mouthpiece, a mask will be used. NebuTech® HDN® nebulizer: All treatments in the NebuTech® arm will be given at a standard dilution of 5 ml (diluted with normal saline to a total volume of 5 ml as per the manufacturer's recommendation). Patients in this arm will receive up to four treatments with parameters measured after each treatment, similar to the control arm. Patient
    All Cause Mortality
    Hudson RCI® Nebulizer NebuTech® HDN® Nebulizer
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/0 (NaN) 0/0 (NaN)
    Serious Adverse Events
    Hudson RCI® Nebulizer NebuTech® HDN® Nebulizer
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/0 (NaN) 0/0 (NaN)
    Other (Not Including Serious) Adverse Events
    Hudson RCI® Nebulizer NebuTech® HDN® Nebulizer
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/0 (NaN) 0/0 (NaN)

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

    Results Point of Contact

    Name/Title Director Pediatric Fellowship
    Organization Seton Family of Hospital
    Phone 512-324-9999
    Email a.a@abc.com
    Responsible Party:
    Seton Healthcare Family
    ClinicalTrials.gov Identifier:
    NCT01951378
    Other Study ID Numbers:
    • CR-13-119
    First Posted:
    Sep 26, 2013
    Last Update Posted:
    Apr 8, 2021
    Last Verified:
    Aug 1, 2020