Inhaled Albuterol and Oral Prednisone Therapy in Hospitalized Adult Asthmatics: Methods (3)

Each patient received albuterol, 2.5 mg in 3 ml of saline solution nebulized via a mouthpiece from a hand held jet nebulizer, driven by 100 percent oxygen at a flow of 6 L/min every two hours for four doses and then every four hours for the duration of hospitalization. If the patient response dictated more intensive therapy, every one or two hours nebulized albuterol doses (2.5 mg) were given. Each patient received oral prednisone, 0.5 mg/kg every six hours for the duration of the study, and each patient received oxygen therapy by nasal prongs to assure at least 90 percent saturation of the hemoglobin. If additional therapy was required, subcutaneous epinephrine or terbutaline was given and/or nebulized glycopyrrolate.
Although the primary evaluation of patient response was bedside spirometry, subjective patient assessment of the treatment was also done on a scale of 1 to 5, which corresponded with much worse (1), worse (2), same (3), better (4), much better (5). In addition, aminophylline and placebo groups were compared for duration of hospital stay.
Statistical Analysis
The mean and standard error of the mean were used to express the central tendency of the data. Admission and discharge data for both patient groups were compared using a two-sample Students f-test for unpaired data. Pulmonary (unction tests performed at each time point were analyzed using a two-way analysis of variance (ANOVA) with one between-subject factor (placebo-aminophylline), and one within-subject factor (time, baseline [0 h] to 32 h). Subjective patient assessment was evaluated using a repeated measures ANOVA for all patients having two or more scores. Bonferroni comparisons at the 0.05 significance level were made between placebo and aminophylline at each time point. Minimum detectable differences for the Bonferroni comparisons were computed for alpha=0.05 and beta=0.2 using the appropriate mean square error, degrees of freedom, and sample size.

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