Bronchodilator delivery with metered-dose inhalers in mechanically-ventilated patients

Rajiv Dhand, M. J. Tobin

Research output: Contribution to journalReview article

59 Citations (Scopus)

Abstract

Metered-dose inhalers (MDIs) provide several advantages over nebulizers, including ease of administration, decreased cost, reliability of dosing, and freedom from contamination. However, this method of aerosol delivery has been considered ineffective in mechanically-ventilated patients because most of the aerosol deposits in the endotracheal tube and ventilator circuit. A smaller amount of aerosol from a MDI is deposited in the lower respiratory tract of mechanically-ventilated patients than in ambulatory patients, although recent studies show that a significant bronchodilator effect can still be achieved. When employed optimally, significant bronchodilation occurs with as little as 4 puffs of a sympathomimetic aerosol. Multiple factors influence the efficacy of MDIs in mechanically-ventilated patients. The method of connecting the MDI canister to the ventilator circuit has a marked effect on aerosol delivery, and other factors include the timing of MDI actuation, ventilator mode, tidal volume, circuit humidity, and duty cycle. With a proper technique of administration, a MDI serves as an effective, convenient, and safe method for delivering bronchodilator aerosols in mechanically-ventilated patients.

Original languageEnglish (US)
Pages (from-to)585-595
Number of pages11
JournalEuropean Respiratory Journal
Volume9
Issue number3
DOIs
StatePublished - Mar 1 1996

Fingerprint

Metered Dose Inhalers
Bronchodilator Agents
Aerosols
Mechanical Ventilators
Sympathomimetics
Nebulizers and Vaporizers
Tidal Volume
Humidity
Respiratory System
Costs and Cost Analysis

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

Cite this

Bronchodilator delivery with metered-dose inhalers in mechanically-ventilated patients. / Dhand, Rajiv; Tobin, M. J.

In: European Respiratory Journal, Vol. 9, No. 3, 01.03.1996, p. 585-595.

Research output: Contribution to journalReview article

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