The Science Journal of the American Association for Respiratory Care

1998 OPEN FORUM Abstracts

EXAMINATION OF CLINICAL RESPONSE TO AEROSOLIZED ALBUTEROL ADMINISTERED BY TWO METHODS

by Beth Brown, RRT Macon State College Macon, Georgia

Bronchial smooth muscle hypertrophy has been documented in infants with chronic lung disease. Some of the high airway resistance may be caused by bronchospasm. This bronchospasm may be relieved by inhaled bronchodilators. The purpose of the study is to examine clinical response to aerosolized bronchodilator administered by two methods of aerosol delivery in mechanically ventilated neonatal subjects. Albuterol is delivered to the mechanically ventilated infant by metered dose inhaler and spacer or by gas powered Mini Heart^{TM} nebulizer. Method: Measurements were taken pre-bronchodilator, immediately after bronchodilator, 30 minutes after bronchodilator, and 60 minutes after bronchodilator. These measurements included oxygen saturation by pulse oximetry (SpO2), heart rate, airway resistance, work of breathing, and compliance. Infants served as their own controls in a randomized crossover design, with a washout period between alternate methods of aerosol delivery. The results are:

average % average % change

change in in resistance

compliance

Mini Heart 47%[uparrow] 18%[uparrow]

^{TM} nebulizer

MDI 21%[uparrow] 5%[downarrow]

average % change

in work of

breathing

Mini Heart 29%[downarrow]

^{TM} nebulizer

MDI No change

The univariate approach was used for the test of drug response over time of measure. There were no statistically significant differences to method of drug delivery for each variable. However the univariate approach revealed a significant difference in work of breathing between the average of post and thirty minutes compared to sixty minutes. None of the responses to drug across times of measure was significant (p > 0.05) with the exception of work of breathing. The univariate approach revealed a significant difference in work of breathing between the average of post and 30 minutes compared to 60 minutes (p = 0.013). There was no difference between a bronchodilator delivered by Mini heart nebulizer or MDI in the sample studied. Even though there was no statistical significance in the study, one can not overlook the improvement in compliance, the decrease in resistance, and the decrease in work of breathing after the delivery of aerosolized albuterol by either method of drug delivery.

Conclusion: With the small number of subjects actually enrolled in the study (n =5), the sample size was too small to achieve statistical significance for changes in the variables measured with the two methods of aerosol delivery.

The 44th International Respiratory Congress Abstracts-On-DiskĀ®, November 7 - 10, 1998, Atlanta, Georgia.

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