The Science Journal of the American Association for Respiratory Care
Background: Aerosolized albuterol is commonly administered to mechanically ventilated children in the PICU. Many institutions have favored switching from nebulized albuterol to MDIs since the latter is more cost-effective. To administer albuterol to intubated children via MDI, several spacers are commercially available. This study compared the efficiency of albuterol delivery among four spacers. A secondary objective was to quantify albuterol rainout within the spacer.
Methods: The model consisted of a Bird VIP ventilator in a volume mode to simulate a 15-kg child with moderate lung disease: VT 150 mL (10 mL/kg), PIP 45 cm H2O, rate 12, Ti 0.75 sec, PEEP 4 cm H2O, FiO2 0.4, ventilator flow 11 L/min, and gas conditioned to 34
Results: Mean (SD) albuterol delivery is presented below.
|Spacer Brand||Albuterol Delivery (%)||Rainout in Spacer (%)|
|ACE ||19.9 (6.4)*||57.9 (6.1)|
|Aerochamber ||26.8 (2.6)?||37.0 (9.1)|
|Aerovent ||6.6 (0.9)||71.3 (10.0)|
|Minispacer ||8.5 (0.2)||35.1 (9.5)|
|* p<0.05 compared to Aerovent |
CONCLUSION: There are clinically important differences in albuterol delivery between four commonly used spacers. The Aerochamber