Serum albuterol levels in mechanically ventilated patients and healthy subjects after metered-dose inhaler administration

Alexander Duarte, R. Dhand, R. Reid, J. B. Fink, P. J. Fahey, M. J. Tobin, J. W. Jenne

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

In mechanically ventilated patients, systemic blood levels of inhaled drugs reflect absorption from the lower respiratory tract alone since, unlike nonintubated patients, oropharyngeal and gastrointestinal absorption cannot occur. To determine the efficiency of aerosol administration by a metered-dose inhaler (MDI), we measured serum albuterol levels after administration by a MDI and spacer to nine mechanically ventilated patients (10 puffs) and to 10 healthy subjects (six puffs). Serum albuterol levels (± SEM) quantitated by high-performance liquid chromatography and electrochemical detection were: 0.09 ± 0.04 mg/ml/puff at baseline, 0.66 ± 0.10 at 5 min, 0.98 ± 0.10 at 10 min, 0.56 ± 0.08 at 15 min, and 0.37 ± 0.03 at 30 min in mechanically ventilated patients versus zero at baseline, 0.89 ± 0.12 at 5 min, 1.27 ± 0.13 at 10 min, 0.84 ± 0.09 at 15 min, and 0.53 ± 0.07 at 30 min in control subjects (p ≤ 0.07 at 5, 10, and 30 min; p ≤ 0.05 at baseline and at 15 min). Area under the curve (AUC0-30) in the mechanically ventilated patients was 16.8 ± 1.4 versus 23.4 ± 1.9 ng/ml/puff x min in control subjects (p = 0.014). In summary, administration of albuterol with a MDI achieved a profile of serum levels in mechanically ventilated patients similar to that in healthy control subjects, but the peak serum level and systemic bioavailability (AUC0-30) were lower in the patients. In conclusion, serum levels reliably assess lower respiratory tract deposition of albuterol, and show that MDIs are more efficient for aerosol delivery in mechanically ventilated patients than was previously reported in studies using radiolabeled aerosols.

Original languageEnglish (US)
Pages (from-to)1658-1663
Number of pages6
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume154
Issue number6
StatePublished - 1996
Externally publishedYes

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Metered Dose Inhalers
Albuterol
Healthy Volunteers
Serum
Aerosols
Respiratory System
Biological Availability
Area Under Curve
High Pressure Liquid Chromatography

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Serum albuterol levels in mechanically ventilated patients and healthy subjects after metered-dose inhaler administration. / Duarte, Alexander; Dhand, R.; Reid, R.; Fink, J. B.; Fahey, P. J.; Tobin, M. J.; Jenne, J. W.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 154, No. 6, 1996, p. 1658-1663.

Research output: Contribution to journalArticle

Duarte, Alexander ; Dhand, R. ; Reid, R. ; Fink, J. B. ; Fahey, P. J. ; Tobin, M. J. ; Jenne, J. W. / Serum albuterol levels in mechanically ventilated patients and healthy subjects after metered-dose inhaler administration. In: American Journal of Respiratory and Critical Care Medicine. 1996 ; Vol. 154, No. 6. pp. 1658-1663.
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abstract = "In mechanically ventilated patients, systemic blood levels of inhaled drugs reflect absorption from the lower respiratory tract alone since, unlike nonintubated patients, oropharyngeal and gastrointestinal absorption cannot occur. To determine the efficiency of aerosol administration by a metered-dose inhaler (MDI), we measured serum albuterol levels after administration by a MDI and spacer to nine mechanically ventilated patients (10 puffs) and to 10 healthy subjects (six puffs). Serum albuterol levels (± SEM) quantitated by high-performance liquid chromatography and electrochemical detection were: 0.09 ± 0.04 mg/ml/puff at baseline, 0.66 ± 0.10 at 5 min, 0.98 ± 0.10 at 10 min, 0.56 ± 0.08 at 15 min, and 0.37 ± 0.03 at 30 min in mechanically ventilated patients versus zero at baseline, 0.89 ± 0.12 at 5 min, 1.27 ± 0.13 at 10 min, 0.84 ± 0.09 at 15 min, and 0.53 ± 0.07 at 30 min in control subjects (p ≤ 0.07 at 5, 10, and 30 min; p ≤ 0.05 at baseline and at 15 min). Area under the curve (AUC0-30) in the mechanically ventilated patients was 16.8 ± 1.4 versus 23.4 ± 1.9 ng/ml/puff x min in control subjects (p = 0.014). In summary, administration of albuterol with a MDI achieved a profile of serum levels in mechanically ventilated patients similar to that in healthy control subjects, but the peak serum level and systemic bioavailability (AUC0-30) were lower in the patients. In conclusion, serum levels reliably assess lower respiratory tract deposition of albuterol, and show that MDIs are more efficient for aerosol delivery in mechanically ventilated patients than was previously reported in studies using radiolabeled aerosols.",
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AU - Fahey, P. J.

AU - Tobin, M. J.

AU - Jenne, J. W.

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N2 - In mechanically ventilated patients, systemic blood levels of inhaled drugs reflect absorption from the lower respiratory tract alone since, unlike nonintubated patients, oropharyngeal and gastrointestinal absorption cannot occur. To determine the efficiency of aerosol administration by a metered-dose inhaler (MDI), we measured serum albuterol levels after administration by a MDI and spacer to nine mechanically ventilated patients (10 puffs) and to 10 healthy subjects (six puffs). Serum albuterol levels (± SEM) quantitated by high-performance liquid chromatography and electrochemical detection were: 0.09 ± 0.04 mg/ml/puff at baseline, 0.66 ± 0.10 at 5 min, 0.98 ± 0.10 at 10 min, 0.56 ± 0.08 at 15 min, and 0.37 ± 0.03 at 30 min in mechanically ventilated patients versus zero at baseline, 0.89 ± 0.12 at 5 min, 1.27 ± 0.13 at 10 min, 0.84 ± 0.09 at 15 min, and 0.53 ± 0.07 at 30 min in control subjects (p ≤ 0.07 at 5, 10, and 30 min; p ≤ 0.05 at baseline and at 15 min). Area under the curve (AUC0-30) in the mechanically ventilated patients was 16.8 ± 1.4 versus 23.4 ± 1.9 ng/ml/puff x min in control subjects (p = 0.014). In summary, administration of albuterol with a MDI achieved a profile of serum levels in mechanically ventilated patients similar to that in healthy control subjects, but the peak serum level and systemic bioavailability (AUC0-30) were lower in the patients. In conclusion, serum levels reliably assess lower respiratory tract deposition of albuterol, and show that MDIs are more efficient for aerosol delivery in mechanically ventilated patients than was previously reported in studies using radiolabeled aerosols.

AB - In mechanically ventilated patients, systemic blood levels of inhaled drugs reflect absorption from the lower respiratory tract alone since, unlike nonintubated patients, oropharyngeal and gastrointestinal absorption cannot occur. To determine the efficiency of aerosol administration by a metered-dose inhaler (MDI), we measured serum albuterol levels after administration by a MDI and spacer to nine mechanically ventilated patients (10 puffs) and to 10 healthy subjects (six puffs). Serum albuterol levels (± SEM) quantitated by high-performance liquid chromatography and electrochemical detection were: 0.09 ± 0.04 mg/ml/puff at baseline, 0.66 ± 0.10 at 5 min, 0.98 ± 0.10 at 10 min, 0.56 ± 0.08 at 15 min, and 0.37 ± 0.03 at 30 min in mechanically ventilated patients versus zero at baseline, 0.89 ± 0.12 at 5 min, 1.27 ± 0.13 at 10 min, 0.84 ± 0.09 at 15 min, and 0.53 ± 0.07 at 30 min in control subjects (p ≤ 0.07 at 5, 10, and 30 min; p ≤ 0.05 at baseline and at 15 min). Area under the curve (AUC0-30) in the mechanically ventilated patients was 16.8 ± 1.4 versus 23.4 ± 1.9 ng/ml/puff x min in control subjects (p = 0.014). In summary, administration of albuterol with a MDI achieved a profile of serum levels in mechanically ventilated patients similar to that in healthy control subjects, but the peak serum level and systemic bioavailability (AUC0-30) were lower in the patients. In conclusion, serum levels reliably assess lower respiratory tract deposition of albuterol, and show that MDIs are more efficient for aerosol delivery in mechanically ventilated patients than was previously reported in studies using radiolabeled aerosols.

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