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Bronchodilator delivery by metered-dose inhaler in ventilator-supported patients.
Am J Respir Crit Care Med. 1995 Jun; 151(6):1827-33.AJ

Abstract

The optimal dose and technique for administration of bronchodilators with a metered-dose inhaler (MDI) in mechanically ventilated patients have not been established. We studied the efficacy and safety of 10 puffs (90 micrograms/puff) of albuterol administered by an MDI in seven mechanically ventilated patients with chronic obstructive pulmonary disease (COPD). Rapid airway occlusions at constant flow inflation were performed before and at 5-min intervals after administration of albuterol for 60 min. Significant decreases in maximum (Rrsmax; p < 0.01) and minimum inspiratory resistance (Rrsmin; p < 0.01) were present at 5 min and persisted for 60 min after administration of albuterol (p < 0.01 for both parameters). Rrsmax indicates maximal inspiratory resistance while Rrsmin represents the ohmic flow resistance. Intrinsic positive end-expiratory pressure decreased significantly (p < 0.05) 15 min after albuterol administration. Heart rate, blood pressure, and arterial oxygenation did not show significant change after albuterol. In summary, 10 puffs of albuterol given by an MDI and spacer produced significant bronchodilation in ventilator-supported patients with COPD, without producing side effects. In conclusion, higher doses of albuterol given by an MDI and spacer could be used routinely in mechanically ventilated patients with COPD.

Authors+Show Affiliations

Division of Pulmonary and Critical Care Medicine, Hines VA Hospital, IL 60141, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

7767526

Citation

Dhand, R, et al. "Bronchodilator Delivery By Metered-dose Inhaler in Ventilator-supported Patients." American Journal of Respiratory and Critical Care Medicine, vol. 151, no. 6, 1995, pp. 1827-33.
Dhand R, Jubran A, Tobin MJ. Bronchodilator delivery by metered-dose inhaler in ventilator-supported patients. Am J Respir Crit Care Med. 1995;151(6):1827-33.
Dhand, R., Jubran, A., & Tobin, M. J. (1995). Bronchodilator delivery by metered-dose inhaler in ventilator-supported patients. American Journal of Respiratory and Critical Care Medicine, 151(6), 1827-33.
Dhand R, Jubran A, Tobin MJ. Bronchodilator Delivery By Metered-dose Inhaler in Ventilator-supported Patients. Am J Respir Crit Care Med. 1995;151(6):1827-33. PubMed PMID: 7767526.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bronchodilator delivery by metered-dose inhaler in ventilator-supported patients. AU - Dhand,R, AU - Jubran,A, AU - Tobin,M J, PY - 1995/6/1/pubmed PY - 1995/6/1/medline PY - 1995/6/1/entrez SP - 1827 EP - 33 JF - American journal of respiratory and critical care medicine JO - Am J Respir Crit Care Med VL - 151 IS - 6 N2 - The optimal dose and technique for administration of bronchodilators with a metered-dose inhaler (MDI) in mechanically ventilated patients have not been established. We studied the efficacy and safety of 10 puffs (90 micrograms/puff) of albuterol administered by an MDI in seven mechanically ventilated patients with chronic obstructive pulmonary disease (COPD). Rapid airway occlusions at constant flow inflation were performed before and at 5-min intervals after administration of albuterol for 60 min. Significant decreases in maximum (Rrsmax; p < 0.01) and minimum inspiratory resistance (Rrsmin; p < 0.01) were present at 5 min and persisted for 60 min after administration of albuterol (p < 0.01 for both parameters). Rrsmax indicates maximal inspiratory resistance while Rrsmin represents the ohmic flow resistance. Intrinsic positive end-expiratory pressure decreased significantly (p < 0.05) 15 min after albuterol administration. Heart rate, blood pressure, and arterial oxygenation did not show significant change after albuterol. In summary, 10 puffs of albuterol given by an MDI and spacer produced significant bronchodilation in ventilator-supported patients with COPD, without producing side effects. In conclusion, higher doses of albuterol given by an MDI and spacer could be used routinely in mechanically ventilated patients with COPD. SN - 1073-449X UR - https://www.unboundmedicine.com/medline/citation/7767526/Bronchodilator_delivery_by_metered_dose_inhaler_in_ventilator_supported_patients_ L2 - https://www.atsjournals.org/doi/10.1164/ajrccm.151.6.7767526?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -