2010 OPEN FORUM Abstracts
EFFICACY, SAFETY, AND PATIENT AND RESPIRATORY THERAPIST SATISFACTION WITH A BREATH ACTUATED NEBULIZER.
Vichaya Arunthari1, Rikki S. Bruinsma2, Augustine S. Lee1, Margaret M. Johnson1; 1Pulmonary Medicine, Mayo Clinic Florida, Jacksonville, FL; 2Respiratory Services, Mayo Clinic Florida, Jacksonville, FL
BACKGROUND: Nebulized drug delivery is a cornerstone of therapy for obstructive lung disease but the ideal nebulizer design is uncertain. Newer nebulizers, such as the breath-actuated nebulizer (BAN) AeroEclipse II® (Monaghan Medical®), may be superior to conventional nebulizers due to reduced drug waste and treatment. The aim of the study was to compare the BAN to standard nebulizer with regards to efficacy, safety, and patient and respiratory therapist satisfaction. METHOD: Adults admitted to the hospital with obstructive airway disease for which nebulizer therapy had been prescribed were asked to participate. Patients were randomly assigned to the order of nebulization delivery device and were surveyed at the completion of each treatment. Respiratory therapists assessed each patients heart rate, respiratory rate, and peak expiratory flow rate (PEFR) prior to and following treatment. Treatment time, and evidence of adverse events (AE) were recorded. Each respiratory therapist conducting the treatment was asked to assess his/her satisfaction with the BAN compared to standard nebulizer. RESULTS: Twenty-eight patients (46% male) were studied. Mean subject age was 69 years. Fifty four percent of patients indicated that overall the BAN was superior to conventional nebulizer therapy; 68% indicated that the time of therapy was preferable with the BAN. Respiratory therapists were more satisfied with the BAN based on overall performance, duration, and ease of use over standard nebulizer. There were no significant differences in heart rate, PEFR, or respiratory rate before or after nebulization therapy with either device. The duration of treatment was significantly lower with the BAN (4.1 vs. 9.9 min p= < 0.001). Additionally, the BAN was associated with a lower occurrence of AE. CONCLUSION: Both patients and respiratory therapists expressed greater satisfaction with the BAN compared with standard nebulizer. Pre and post treatment vital signs did not differ between groups but use of the BAN was associated with a shorter duration of treatment and a lower occurrence of AE. Taken together, these data support the use of the BAN for nebulized medication delivery. Sponsored Research - None Demographics, RT satisfaction, physiologic effects, and duration of BAN compared to standard nebulizer. -BAN=Breath actuated nebulizer, RT= respiratory therapist, SD= standard deviation, CI= confidence interval, -Data presented with mean±SD unless specified, -RT satisfaction scale where 1 meant not satisfied at all and 5 meant extremely satisfied, -Mean difference analyzed using paired analysis with Wilcoxon Signed Rank Test