The Science Journal of the American Association for Respiratory Care

1997 OPEN FORUM Abstracts

COMPARISON OF THE CLINICAL EFFECTS OF ALBUTEROL AEROSOL DELIVERY BY SMALL VOLUME NEBULIZER AND METERED DOSE INHALER IN INTUBATED, MECHANICALLY VENTILATED ADULTS

Sule Sonmez, M.S., RN, Amerikan Hospital, Istanbul, Turkey, Ceyhan Celikoglu, MD, Firuz Celikoglu, MD, Nahit Cokar, MD, Lufti Telci, MD, Istanbul University, Istanbul, Turkey, Randy De Kler, M.S., RRT, Georgia State University, Atlanta, GA

Background: The effective delivery of aerosolized medications to intubated, mechanically ventilated patients continues to challenge clinicians. Advantages and disadvantages exist for both the small volume nebulizer (SVN) and metered dose inhaler (MDI) methods. This study compared the clinical efficacy, based on selected assessment parameters, of the SVN and MDI aerosol delivery routes. Methods: 14 sedated, paralyzed, mechanically ventilated, adult COPD patients were included in the study group. Albuterol was administered to each patient alternately via the SVN and MDI route. Peak inspiratory pressure (PIP), plateau pressure (P_{PLAT}), airway resistance (R_{AW}), and auto-PEEP were measured before and fifteen minutes after each treatment. Results:

Mean decrease after treatment

PIP P_{PLAT} R_{AW} auto-PEEP

SVN 5.87 3.42 4.22 2.21

MDI 4.75 2.72 3.62 1.35

p 0.19 0.28 0.47 0.03

Conclusions: No statistically significant difference was found for PIP, P_{PLAT}, or R_{AW} between the two methods. The SVN method resulted in a decrease in auto-PEEP that reached statistical significance (p=0.03). This value, while statistically significant, may not be clinically important.

OF-97-087

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