Background:Breath-actuated inhalers (BAIs) are increasingly used in clinical practice due to simplicity of usage, fewer technique errors & patient preference.However, data on their role in management of acute exacerbations in children is limited

Aim:This open-label, pilot study aimed to evaluate efficacy & usability of levosalbutamol delivered through BAI in mild-moderate acute asthma exacerbations in children

Methods:Children (7-15 yrs) with physician-diagnosed asthma, presenting to outpatient department with mild-moderate asthma exacerbation as per GINA 2022 classification, were administered levosalbutamol 50mcg (Levolin®) through BAI (Synchrobreathe®) as 4 puffs every 20 min, for 1 hr.Clinical response was assessed using pulmonary score based on respiratory rate, wheezing & accessory muscle usage.Device usability questionnaire was administered at end of study.

Results:Total of 57 children (60%M; age 10.2±2.5 yrs) with mild (86%) or moderate (12.3%) asthma exacerbations were enrolled. 52 (91.2%) children responded well & improved clinically at 60 mins.Average pulmonary score decreased (p<0.001) from 5.12 units at baseline to 4.32, 2.54 and 1.67 units at 20, 40 & 60 mins, respectively.Five (8.8%) patients required other interventions (viz. O2, nebulization, MDI+spacer).All participants reported Synchrobreathe® as child-friendly, 84% found it easy to breathe through & 91.2% were able to trigger it during an exacerbation

Conclusion:Most children presenting with a mild-moderate asthma exacerbation showed significant improvement in pulmonary score after treatment with levosalbutamol delivered through Synchrobreathe® and also found the BAI to be child-friendly and easy to use during an exacerbation