Document Detail


Bronchodilator therapy with metered-dose inhaler and spacer versus nebulizer in mechanically ventilated patients: comparison of magnitude and duration of response.
MedLine Citation:
PMID:  10926377     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Four-hour comparison of the bronchodilator response of albuterol administered via metered-dose inhaler (MDI) with spacer versus small-volume nebulizer (SVN) to mechanically ventilated patients with chronic obstructive pulmonary disease (COPD). DESIGN: Prospective randomized clinical trial. SETTING: Medical intensive care unit in a university hospital. PATIENTS: Thirteen mechanically ventilated COPD patients. INTERVENTION: Albuterol administration of 4 puffs (0.4 mg) or 10 puffs (1.0 mg) via MDI with spacer or 2.5 mg via SVN to mechanically ventilated patients in order to assess the bronchodilator response over 4 hours. MEASUREMENTS AND RESULTS: Mechanically ventilated patients were enrolled in a randomized crossover study wherein one group received 4 puffs (0.4 mg) or 2.5 mg of albuterol and another group received 10 puffs (1.0 mg) or 2.5 mg of albuterol on separate days. Respiratory mechanics measurements were obtained over 4 hours. Total airway resistance declined by 14.4 +/- 3.8% after 4 MDI puffs, 18.3 +/- 1.8% after 10 MDI puffs, or 13.7 +/- 2.6% after 2.5 mg via SVN, compared to baseline (p < 0.01). After albuterol delivery, airway resistance remained improved for 90-120 minutes (p < 0.05) and returned to baseline by 4 hours with all treatments. CONCLUSION: The airway response to albuterol administration via MDI and SVN to mechanically ventilated patients was similar in magnitude and duration, returning to baseline by 240 minutes. In stable, mechanically ventilated COPD patients, albuterol may be administered via MDI with spacer or via SVN every 4 hours.
Authors:
A G Duarte; K Momii; A Bidani
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Respiratory care     Volume:  45     ISSN:  0020-1324     ISO Abbreviation:  Respir Care     Publication Date:  2000 Jul 
Date Detail:
Created Date:  2000-11-08     Completed Date:  2000-11-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  817-23     Citation Subset:  IM    
Affiliation:
Department of Pulmonary Care, University of Texas Medical Branch, Galveston 77555-0561, USA. aduarte@utmb.edu
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Aerosols
Airway Resistance / drug effects
Albuterol / administration & dosage*
Bronchodilator Agents / administration & dosage*
Cross-Over Studies
Follow-Up Studies
Forced Expiratory Volume / drug effects
Humans
Lung Diseases, Obstructive / physiopathology,  therapy*
Middle Aged
Nebulizers and Vaporizers*
Positive-Pressure Respiration*
Prospective Studies
Respiratory Care Units
Chemical
Reg. No./Substance:
0/Aerosols; 0/Bronchodilator Agents; 18559-94-9/Albuterol
Comments/Corrections
Comment In:
Respir Care. 2000 Jul;45(7):815-6   [PMID:  10926376 ]

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


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