Document Detail


Albuterol delivery by metered-dose inhaler in a mechanically ventilated pediatric lung model.
MedLine Citation:
PMID:  8706467     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To assess albuterol delivery by metered-dose inhaler in a mechanically ventilated pediatric lung model and to determine the influence of the following variables on albuterol delivery: endotracheal tube diameter; type of spacer; humidification; and pulmonary mechanics. DESIGN: Prospective, in vitro, laboratory study. SETTING: Research laboratory. INTERVENTIONS: A model, consisting of a volume-cycled ventilator, pediatric breathing circuit, 4.0- or 6.0-mm endotracheal tube, and lung simulator, was assembled. Ventilator settings were: tidal volume 250 mL; FIO2 0.5; inspiration/expiration ratio 1:3; respiratory rate 25 breaths/min; positive end-expiratory pressure 3 cm H2O; temperature 35 degrees C; and a decelerating flow pattern, using dry and humidified air. Lung simulator compliance and resistance values were consistent with those values reported for healthy childeren (20 mL/cm H2O and 40 cm H20/L/sec) and children with pulmonary disease (10 mL/cm H2O and 60 cm H2O/L/sec). Pulmonary mechanics were verified with a pulmonary function diagnostic system. Ten metered-dose inhaler canisters were used to administer 2000 micrograms of albuterol, using either a collapsible or a rigid spacer. A circuit filter placed immediately proximal to the test lung collected drug exiting the endotracheal tube. The filter was rinsed with water and albuterol concentrations were determined by high-performance liquid chromatography. Each variable was tested in triplicate. MEASUREMENTS AND MAIN RESULTS: Albuterol delivery was significantly (p < or = .05) greater for the 6.0-mm endotracheal tube, rigid spacer, dry air, and pulmonary disease mechanics by multifactor analysis of variance. Drug delivery in humidified air with pulmonary disease mechanics using the rigid chamber was 2.5 =/- 0.27% and 6.3 =/- 0.99% for the 4.0- and 6.0-mm endotracheal tubes, respectively. CONCLUSIONS: These in vitro results suggest that pulmonary disease mechanics and a 6.0-mm endotracheal tube improve albuterol delivery. Future clinical investigations in intubated pediatric patients with pulmonary disease are needed to address the clinical significance of these results.
Authors:
S S Garner; D B Wiest; J W Bradley; B A Lesher; D M Habib
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  24     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  1996 May 
Date Detail:
Created Date:  1996-09-10     Completed Date:  1996-09-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  870-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Pharmaceutical Sciences, Medical University of South Carolina, Charleston 29425-0810, USA.
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MeSH Terms
Descriptor/Qualifier:
Albuterol / administration & dosage*
Asthma / drug therapy*,  physiopathology
Bronchodilator Agents / administration & dosage*
Child
Disease Models, Animal
Drug Delivery Systems / instrumentation*
Drug Evaluation, Preclinical
Humans
Nebulizers and Vaporizers*
Prospective Studies
Respiration, Artificial / instrumentation,  methods*
Respiratory Mechanics
Chemical
Reg. No./Substance:
0/Bronchodilator Agents; 18559-94-9/Albuterol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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