BRONCHODILATOR DELIVERY BY METERED-DOSE INHALER IN VENTILATOR-SUPPORTED PATIENTS

被引：59

作者：

DHAND, R ^{[1
]}

JUBRAN, A ^{[1
]}

TOBIN, MJ ^{[1
]}

机构：

[1] LOYOLA UNIV,STRITCH SCH MED,HINES,IL

来源：

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE | 1995年 / 151卷 / 06期

关键词：

D O I：

10.1164/ajrccm.151.6.7767526

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

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 mu g/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)min represents the ohmic flow resistance. Intrinsic positive end-expiratory pressure decreased significantly (p < 005) 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.

引用

页码：1827 / 1833

页数：7

共 30 条

[1]

Gross N.J., Jenne J.W., Hess D., Bronchodilator therapy, Principles and Practice of Mechanical Ventilation, pp. 1077-1123, (1994)

[2]

Newhouse M.T., Fuller H.D., Rose is a rose is a rose? Aerosol therapy in ventilated patients: Nebulizers versus metered dose inhalers - A continuing controversy, Am. Rev. Respir. Dis., 148, pp. 1444-1446, (1993)

[3]

MacIntyre N.R., Silver R.M., Miller C.W., Schuler F., Coleman E.R., Aerosol delivery in intubated, mechanically ventilated patients, Crit. Care Med., 13, pp. 81-84, (1985)

[4]

Fuller H.D., Dolovich M.B., Posmituck G., Wong Pack W., Newhouse M.T., Pressurized aerosol versus jet aerosol delivery to mechanically ventilated patients: Comparison of dose to the lungs, Am. Rev. Respir. Dis., 141, pp. 440-444, (1990)

[5]

Newman S.P., Pavia D., Moren F., Sheahan N.F., Clarke S.W., Deposition of pressurized aerosols in the human respiratory tract, Thorax, 36, pp. 52-55, (1981)

[6]

Dolovich M., Ruffin R.E., Roberts R., Newhouse M.T., Optimal delivery of aerosols from metered dose inhalers, Chest, 80, SUPPL., pp. 911-915, (1981)

[7]

Aerosol consensus statement, Chest, 100, pp. 1106-1109, (1991)

[8]

Gay P.C., Patel H.G., Nelson S.B., Gilles B., Hubmayr R.D., Metered dose inhalers for bronchodilator delivery in intubated, mechanically ventilated patients, Chest, 99, pp. 66-71, (1991)

[9]

Fernandez A., Lazaro A., Garcia A., Aragon C., Cerda E., Bronchodilators in patients with chronic obstructive pulmonary disease on mechanical ventilation: Utilization of metered-dose inhalers, Am. Rev. Respir. Dis., 141, pp. 164-168, (1990)

[10]

Mancebo J., Amaro P., Lorino H., Lemaire F., Harf A., Brochard L., Effects of albuterol inhalation on the work of breathing during weaning from mechanical ventilation, Am. Rev. Respir. Dis., 144, pp. 95-100, (1991)

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