Bronchodilator delivery by metered-dose inhaler in ventilator-supported patients

Rajiv Dhand, Amal Jubran, Martin J. Tobin

Research output: Contribution to journalArticle

72 Citations (Scopus)

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 μg/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 (R(rs)max; p < 0.01) and minimum inspiratory resistance (R(rs)min; p < 0.01) were present at 5 min and persisted for 60 min after administration of albuterol (p < 0.01 for both parameters). R(rs)max indicates maximal inspiratory resistance while R(rs)max 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.

Original languageEnglish (US)
Pages (from-to)1827-1833
Number of pages7
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume151
Issue number6
DOIs
StatePublished - Jan 1 1995
Externally publishedYes

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Metered Dose Inhalers
Albuterol
Bronchodilator Agents
Mechanical Ventilators
Chronic Obstructive Pulmonary Disease
Positive-Pressure Respiration
Economic Inflation
Electric Impedance
Arterial Pressure
Heart Rate
Safety

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Bronchodilator delivery by metered-dose inhaler in ventilator-supported patients. / Dhand, Rajiv; Jubran, Amal; Tobin, Martin J.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 151, No. 6, 01.01.1995, p. 1827-1833.

Research output: Contribution to journalArticle

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