The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

COMPARISON OF A VALVED-HOLDING CHAMBER(VHC)-FACEMASK/ MOUTHPIECE WITH SMALL VOLUME NEBULIZER-FACEMASK (SVNF) FOR BRONCHODILATOR DELIVERY

Mary K. Hart, Erika Abmas, Rose Boehm, Grace Hernandez, Mark Millard; Baylor University Medical Center, Dallas, TX

Background: Aerosolized medications now represent the standard-of-care for asthma. A pressurized metered dose inhaler (pMDI) requires less time to deliver than SVN-F. We report a preliminary study to test the hypothesis that treatment by anti-static VHC-facemask (Aerochamber MAX Monaghan Medical Corp., Plattsburgh, NY, USA) is as effective as via nebulizer-facemask based on Forced Expiratory Volume one second (FEV1) and dyspnea responses. Method: 14 adult subjects diagnosed with asthma demonstrating a 200 ml FEV1 response to inhaled albuterol by spirometry were randomized to 5 treatment modalities using albuterol as the bronchodilator delivered: (1) 2-actuations by metered dose inhaler (pMDI)+VHC-mouthpiece (2) 4-actuations pMDI+VHC-mouthpiece (3) 2-actuations pMDI+VHC-facemask (4) 4-actuations pMDI+VHC-facemask (5) unit dose (2.5mg/3ml) ampule via small volume nebulizer-facemask. Spirometry(FEV1), heart rate, oxygen saturation, perceived work of breathing (BORG), and hand tremor were assessed prior to treatment, at 15 and 30 minutes post bronchodilator. Results: ANOVA of BORG scores improved at baseline (p<0.05) when compared to mean BORG scores at 15 or 30 minutes except with delivery method (5) SVN-F. Mean FEV1 at both 15 and 30 minutes post treatment were measurably higher than baseline values across treatment methods and corresponded well with BORG findings. Conclusions: Additional subjects must be studied to improve to statistical power. The improved patient dyspnea and shortened delivery time indicate that a pMDI albuterol treatment may be an acceptable clinical alternative to aerosol delivery via continuous small volume nebulizer with mask. Sponsored Research - Research Funding provided by Monaghan Medical

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