The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts


Randy Willis1, Bennett Downs1, Ariel Berlinski2,3

Background: Respiratory therapists administer albuterol solutions for inhalation routinely. The drug is dispensed in 2.5mg/3ml or 2.5mg/0.5ml bullets. The latter requires dilution with normal saline that is commercially available in 3, 5, and 15 ml bullets. We hypothesize that premixed vials will provide a more consistent amount of solution to be delivered.

Methods: 25 respiratory therapists working at Arkansas Children's Hospital (56% female, mean age 40.2 years old and 14.5 years post-graduation) participated in this IRB approved study. The subjects loaded the albuterol into a nebulizer (Hudson Updraft II Optineb, Teleflex Medical Ltd., NC) and were instructed to add normal saline to total volume of 3 ml when necessary. Nebulizers were weighted on a precision scale (dry, after loading the albuterol and after loading the saline solution). 2.5mg/3ml or 2.5mg/0.5ml bullets to be diluted using either 3, or 5, or 15 ml saline bullets were used. The testing order was determined using a block balanced design. Measurements were done in triplicate. Mean volumes determined for each situation were loaded in the nebulizer and run until sputtering began (NEB TIME) (n = 5). Time was recorded for each run. Weights were compared by ANOVA followed by Dunnett's procedure if ANOVA was significant. A p value < 0.05 was considered statistically significant.

Results: (see table)

Conclusion: The use of 15ml saline vials to dilute 2.5mg/0.5 ml albuterol vials resulted in a 21% increase in loading volume and an a 60% increase in treatment time. Pre-mixed vials were loaded more consistently. These findings need to be considered by managers when deciding whether to use pre-mixed or undiluted inhalation solutions.