2001 OPEN FORUM Abstracts
THE DELIVERYTIME, EFFICACY, AND SAFETY OF BETA AGONIST BRONCHODILATOR ADMINISTRATION WITHTHE AEROECLIPSE BREATH ACTUATED NEBULIZER VS A CONVENTIONAL T-TYPE SMALL VOLUMENEBULIZER.
Robert S. Pikarsky*, Tracey Farrell,Russ Acevedo, Wendy Fascia and Charles Roman. 1Respiratory Care,Crouse Hospital, Syracuse, New York.
Purpose: Aerosol deliveryconsumes the highest level of Respiratory Care resources. This study evaluatedthe delivery time, efficacy, and safety of rapidly nebulized albuterol withthe use of a novel breath actuated nebulizer compared to a standard small volumenebulizer.
Methods: A consecutive, non-randomized,mostly COPD population receiving pre & post bronchodilator testing in ourPulmonary Function Lab were studied. 0.5 ml Albuterol (2.5 mg) with 0.5 ml NormalSaline (NS) was administered with the AeroEclipse Breath Actuated Nebulizer(BAN) (Monaghan Medical Corp. Plattsburgh, N.Y.) using an oxygen flow rate of8 L/min. Treatments with the Airlife Misty-Neb small volume nebulizer (SVN)(Allegiance Healthcare Corporation) consisted of nebulizing 2.5 mg of albuteroldiluted with 3 ml of Normal Saline Unit Dose (UD) using an oxygen flow rateof 8 L/min. The Sensormedics Vmax 22 Pulmonary Function System was utilizedto measure FEV1. A standardized subjective questionnaire to determine side effectswas completed.
Results: The table shows thealbuterol dosages, mean % change of FEV1 from pre-treatment and 10 minute posttreatment, mean administration time and tremulousness. The mean treatment timewith all BAN patients was 2.67 minutes as compared to 8.33 minutes with theSVN (p<.001)*. The changes in FEV1 were not significant. There was no differencein heart rate, respiratory rate or nausea.
Conclusion: The rapid administrationof Albuterol in the 0.5 ml + 0.5 ml NS dose using the BAN was equally efficaciousas the SVN UD. Delivering 0.5 ml Albuterol (2.5 mg) with 0.5 ml Normal Salineusing the BAN offered the best delivery time, efficacy and safety profile betweenthe two devices.
Clinical Implications: Ina health care facility that delivers large volumes of aerosol treatments, thedecrease in delivery time achieved with the BAN could have a significant impacton resource utilization. The results supported changes in the Respiratory Carepractice throughout Crouse Hospital. Further studies evaluating additional medicationdosing regimens measuring safety, efficacy and resource utilization are needed.
|Nebulizer(n)||Dose||% ChangeFEV1||Time (min)||Tremulousness|
|AeroEclipse(12)||2.5mg (0.5ml albuterol +0.5 ml NS)||8.2%||2.67*||0|
|Misty-Neb(52)||2.5mg (3 mlunit dose)||9.1%||8.33||2|