International Journal of Medicine and Medical Research (IJMMR)

Obstructive bronchitis remains a frequent cause of acute respiratory distress in paediatric care. While bronchodilators remain the standard therapeutic approach, the choice between a nebuliser and a pressurised metereddose inhaler (pMDI) with a valved holding chamber continues to be a subject of clinical debate, particularly regarding younger children. In this prospective observational study, a cohort of 30 children aged 2-8 years was examined to compare the clinical efficacy and usability of these delivery methods. Group A (n = 16) received salbutamol via a jet nebuliser, while Group B (n=14) utilised a pMDI with a Vortex-type spacer. Despite comparable baseline characteristics (p > 0.05), Group B demonstrated accelerated clinical stabilisation, higher levels of child cooperation, and a reduction in the total number of required inhalations. Notably, the incidence of repeat medical consultations and hospitalisations was lower in the spacer group (7.1% for each outcome) compared to the nebuliser group (25.0% and 12.5%, respectively). These findings suggested that a pMDI with a spacer is a highly effective primary tool for managing mild-to-moderate episodes in outpatient and home settings. Nebuliser therapy should be reserved for severe clinical presentations or patients with significant hypoxia and coordination difficulties, typically requiring supervised clinical observation. Integrating spacers into primary care protocols can optimise treatment efficiency and alleviate the burden on hospital facilities by providing reliable management of less severe obstructions

bronchial obstructive syndrome; respiratory conditions; bronchodilators; spacer