Bronchodilator therapy with metered-dose inhaler and spacer versus nebulizer in mechanically ventilated patients

Comparison of magnitude and duration of response

Alexander Duarte, Keith Momii, Akhil Bidani

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)817-823
Number of pages7
JournalRespiratory Care
Volume45
Issue number7
StatePublished - Jul 2000

Fingerprint

Metered Dose Inhalers
Albuterol
Nebulizers and Vaporizers
Bronchodilator Agents
Chronic Obstructive Pulmonary Disease
Airway Resistance
Therapeutics
Respiratory Mechanics
Cross-Over Studies
Intensive Care Units
Randomized Controlled Trials

Keywords

  • Aerosols
  • Albuterol
  • Bronchodilator
  • Inhalation therapy
  • Mechanical ventilation
  • Obstructive lung disease

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

@article{12af185a204947709f2e49feb99f7c42,
title = "Bronchodilator therapy with metered-dose inhaler and spacer versus nebulizer in mechanically ventilated patients: Comparison of magnitude and duration of response",
abstract = "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.",
keywords = "Aerosols, Albuterol, Bronchodilator, Inhalation therapy, Mechanical ventilation, Obstructive lung disease",
author = "Alexander Duarte and Keith Momii and Akhil Bidani",
year = "2000",
month = "7",
language = "English (US)",
volume = "45",
pages = "817--823",
journal = "Respiratory Care",
issn = "0098-9142",
publisher = "Daedalus Enterprises Inc.",
number = "7",

}

TY - JOUR

T1 - Bronchodilator therapy with metered-dose inhaler and spacer versus nebulizer in mechanically ventilated patients

T2 - Comparison of magnitude and duration of response

AU - Duarte, Alexander

AU - Momii, Keith

AU - Bidani, Akhil

PY - 2000/7

Y1 - 2000/7

N2 - 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.

AB - 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.

KW - Aerosols

KW - Albuterol

KW - Bronchodilator

KW - Inhalation therapy

KW - Mechanical ventilation

KW - Obstructive lung disease

UR - http://www.scopus.com/inward/record.url?scp=0034223152&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034223152&partnerID=8YFLogxK

M3 - Article

VL - 45

SP - 817

EP - 823

JO - Respiratory Care

JF - Respiratory Care

SN - 0098-9142

IS - 7

ER -