The Science Journal of the American Association for Respiratory Care

2001 OPEN FORUM Abstracts

THE DELIVERYTIME, EFFICACY, AND SAFETY OF BETA AGONIST BRONCHODILATOR ADMINISTRATION WITHAN MDI AND VALVED HOLDING CHAMBER VS A CONVENTIONAL T-TYPE NEBULIZER.

Robert S. Pikarsky*, Tracey Farrell,Russ Acevedo, Wendy Fascia and Charles Roman. 1Respiratory Care,Crouse Hospital, Syracuse, New York.

Purpose: Aerosol delivery consumes the highest level of Respiratory Careresources. This study evaluated the delivery time, efficacy, and safety of albuteroladministration with the use of a pMDI with a valved holding chamber (VHC) anda standard small volume nebulizer (SVN).

Methods: A consecutive, non-randomized,mostly COPD population receiving pre & post bronchodilator testing in ourPulmonary Function Lab were studied. Two puffs of albuterol were administeredby pMDI with AeroChamber VHC (Monaghan Medical Corp. Plattsburgh, N.Y.). Treatmentswith the Airlife Misty-Neb Nebulizer SVN (Allegiance Healthcare Corporation)consisted of nebulizing 2.5 mg of albuterol diluted with 3 ml of Normal SalineUnit Dose (UD) using an oxygen flow rate of 8 L/min. The Sensormedics Vmax 22Pulmonary Function System was utilized to measure FEV1. A standardized subjectivequestionnaire to determine side effects was completed. Results: The table shows the albuterol dosages, mean % change of FEV1from pre-treatment and 10 minute post treatment, mean administration time andtremulousness. The mean treatment time with the pMDI was 2.86 minutes as comparedto 8.33 minutes with the SVN (p<.001)*. The changes in FEV1 were not significant.There was no difference in heart rate, respiratory rate or nausea.

Conclusion: In this patientpopulation of mostly stable COPD patients 2 puffs of albuterol from an pMDIwith a valved holding chamber was equally as efficacious as the SVN with unitdose. The pMDI with VHC offered the best delivery time, efficacy and safetyprofile between the two aerosol delivery devices.

Clinical Implications: Ina health care facility that delivers large volumes of aerosol treatments, thedecrease in delivery time realized by the pMDI/VHC delivery method could havea significant impact on resource utilization. Further studies evaluating additionalmedication dosing regimens measuring safety, efficacy and resource utilizationare needed.

Nebulizer(n)Dose% ChangeFEV1Time(min)Tremulousness
MDI (21)180mg - 2puffs8.5%2.86*1
Misty-Neb(52)2,500mg UD9.1%8.332

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