Inhaled drug delivery in mechanically-ventilated patients

Rajiv Dhand, M. J. Tobin

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Therapeutic aerosols are commonly used in mechanically-ventilated patients, yet there is a paucity of information regarding their efficacy and optimal technique of administration. A smaller amount of aerosol deposits in the lower respiratory tract of mechanically-ventilated patients than in ambulatory patients, although a significant therapeutic response can still be achieved. Multiple factors (including the type of aerosol generating device, the timing of aerosol production, ventilator mode, tidal volume, circuit humidity, and duty cycle) influence the efficacy of aerosol delivery and deposition in mechanically-ventilated patients. β-adrenergic and anticholinergic bronchodilators are the most commonly used aerosols in patients receiving mechanical ventilation but corticosteroids, antibiotics, surfactants, and mucokinetic agents are also employed. Traditionally, nebulizers have been used for bronchodilator therapy in patients receiving mechanical ventilation, although metered-dose inhalers (MDIs) are equally effective. With MDIs, the method of connecting the MDI canister to the ventilator circuit has a marked effect on aerosol delivery. When employed optimally, significant bronchodilation occurs with as little as 4 puffs of salbutamol (albuterol) aerosol given by a MDI or 2.5 mg by a nebulizer. With a proper technique of administration, inhaled drugs can be administered safely, conveniently, and effectively in mechanically-ventilated patients. MDIs provide several advantages over nebulizers, including ease of administration, decreased cost, reliability of dosing, and freedom from contamination, and, thus, are preferred for bronchodilator delivery in mechanically-ventilated patients.

Original languageEnglish (US)
Pages (from-to)139-161
Number of pages23
JournalEuropean Respiratory Monograph
Volume3
Issue number8
StatePublished - 1998
Externally publishedYes

Fingerprint

Aerosols
Metered Dose Inhalers
Pharmaceutical Preparations
Nebulizers and Vaporizers
Bronchodilator Agents
Albuterol
Mechanical Ventilators
Artificial Respiration
Tidal Volume
Cholinergic Antagonists
Humidity
Surface-Active Agents
Respiratory System
Adrenergic Agents
Adrenal Cortex Hormones
Therapeutics
Anti-Bacterial Agents
Costs and Cost Analysis
Equipment and Supplies

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

Cite this

Inhaled drug delivery in mechanically-ventilated patients. / Dhand, Rajiv; Tobin, M. J.

In: European Respiratory Monograph, Vol. 3, No. 8, 1998, p. 139-161.

Research output: Contribution to journalReview article

@article{e9e02691cb2c4fe4bfe40e6b97b18825,
title = "Inhaled drug delivery in mechanically-ventilated patients",
abstract = "Therapeutic aerosols are commonly used in mechanically-ventilated patients, yet there is a paucity of information regarding their efficacy and optimal technique of administration. A smaller amount of aerosol deposits in the lower respiratory tract of mechanically-ventilated patients than in ambulatory patients, although a significant therapeutic response can still be achieved. Multiple factors (including the type of aerosol generating device, the timing of aerosol production, ventilator mode, tidal volume, circuit humidity, and duty cycle) influence the efficacy of aerosol delivery and deposition in mechanically-ventilated patients. β-adrenergic and anticholinergic bronchodilators are the most commonly used aerosols in patients receiving mechanical ventilation but corticosteroids, antibiotics, surfactants, and mucokinetic agents are also employed. Traditionally, nebulizers have been used for bronchodilator therapy in patients receiving mechanical ventilation, although metered-dose inhalers (MDIs) are equally effective. With MDIs, the method of connecting the MDI canister to the ventilator circuit has a marked effect on aerosol delivery. When employed optimally, significant bronchodilation occurs with as little as 4 puffs of salbutamol (albuterol) aerosol given by a MDI or 2.5 mg by a nebulizer. With a proper technique of administration, inhaled drugs can be administered safely, conveniently, and effectively in mechanically-ventilated patients. MDIs provide several advantages over nebulizers, including ease of administration, decreased cost, reliability of dosing, and freedom from contamination, and, thus, are preferred for bronchodilator delivery in mechanically-ventilated patients.",
author = "Rajiv Dhand and Tobin, {M. J.}",
year = "1998",
language = "English (US)",
volume = "3",
pages = "139--161",
journal = "European Respiratory Monograph",
issn = "1025-448X",
publisher = "European Respiratory Society",
number = "8",

}

TY - JOUR

T1 - Inhaled drug delivery in mechanically-ventilated patients

AU - Dhand, Rajiv

AU - Tobin, M. J.

PY - 1998

Y1 - 1998

N2 - Therapeutic aerosols are commonly used in mechanically-ventilated patients, yet there is a paucity of information regarding their efficacy and optimal technique of administration. A smaller amount of aerosol deposits in the lower respiratory tract of mechanically-ventilated patients than in ambulatory patients, although a significant therapeutic response can still be achieved. Multiple factors (including the type of aerosol generating device, the timing of aerosol production, ventilator mode, tidal volume, circuit humidity, and duty cycle) influence the efficacy of aerosol delivery and deposition in mechanically-ventilated patients. β-adrenergic and anticholinergic bronchodilators are the most commonly used aerosols in patients receiving mechanical ventilation but corticosteroids, antibiotics, surfactants, and mucokinetic agents are also employed. Traditionally, nebulizers have been used for bronchodilator therapy in patients receiving mechanical ventilation, although metered-dose inhalers (MDIs) are equally effective. With MDIs, the method of connecting the MDI canister to the ventilator circuit has a marked effect on aerosol delivery. When employed optimally, significant bronchodilation occurs with as little as 4 puffs of salbutamol (albuterol) aerosol given by a MDI or 2.5 mg by a nebulizer. With a proper technique of administration, inhaled drugs can be administered safely, conveniently, and effectively in mechanically-ventilated patients. MDIs provide several advantages over nebulizers, including ease of administration, decreased cost, reliability of dosing, and freedom from contamination, and, thus, are preferred for bronchodilator delivery in mechanically-ventilated patients.

AB - Therapeutic aerosols are commonly used in mechanically-ventilated patients, yet there is a paucity of information regarding their efficacy and optimal technique of administration. A smaller amount of aerosol deposits in the lower respiratory tract of mechanically-ventilated patients than in ambulatory patients, although a significant therapeutic response can still be achieved. Multiple factors (including the type of aerosol generating device, the timing of aerosol production, ventilator mode, tidal volume, circuit humidity, and duty cycle) influence the efficacy of aerosol delivery and deposition in mechanically-ventilated patients. β-adrenergic and anticholinergic bronchodilators are the most commonly used aerosols in patients receiving mechanical ventilation but corticosteroids, antibiotics, surfactants, and mucokinetic agents are also employed. Traditionally, nebulizers have been used for bronchodilator therapy in patients receiving mechanical ventilation, although metered-dose inhalers (MDIs) are equally effective. With MDIs, the method of connecting the MDI canister to the ventilator circuit has a marked effect on aerosol delivery. When employed optimally, significant bronchodilation occurs with as little as 4 puffs of salbutamol (albuterol) aerosol given by a MDI or 2.5 mg by a nebulizer. With a proper technique of administration, inhaled drugs can be administered safely, conveniently, and effectively in mechanically-ventilated patients. MDIs provide several advantages over nebulizers, including ease of administration, decreased cost, reliability of dosing, and freedom from contamination, and, thus, are preferred for bronchodilator delivery in mechanically-ventilated patients.

UR - http://www.scopus.com/inward/record.url?scp=0031670724&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031670724&partnerID=8YFLogxK

M3 - Review article

AN - SCOPUS:0031670724

VL - 3

SP - 139

EP - 161

JO - European Respiratory Monograph

JF - European Respiratory Monograph

SN - 1025-448X

IS - 8

ER -