The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

A COMPARISON OF THE EFFECTIVENESS OF THE BREATH ACTUATED NEBULIZER VS. THE MISTY NEBULIZER IN PATIENTS >2 Y.O WITH A PRIMARY DIAGNOSIS OF ASTHMA.

Laurie Smrz, Khris O’Brien; Respiratory Care Services, Children’s Hospital of WI, Milwaukee, WI

Background: In an effort to improve patient outcomes related to asthma care at Children’s Hospital of Wisconsin, the Respiratory Care Department performed an evaluation of two specific small volume nebulizers. Methods: Retrospective chart analysis was performed using the outcomes criteria for 6 weeks pre and post implementation of Breath Actuated Nebulizer (BAN) (i.e. 6 weeks misty neb vs 6 weeks BAN). Retrospective chart analysis comparing the following outcome specific criteria: Number of Treatments; Hours on Oxygen; Length of Stay (LOS) Inclusion Criteria: Pts ≥ 2 and <18 years of age; Pts with primary diagnosis of asthma; Pts ordered on CHW approved medications (albuterol, ipratroprium bromide, budesonide) Exclusion Criteria: Pts < 2 years of age; All pts ordered on Levalbuterol; Pts with a primary diagnosis of asthma along with RSV, bronchiolitis, or pneumonia; Pts who required continuous aerosol therapy Demographic information available on accompanying tables. Misty Neb: All medications diluted to a minimum of 3ml. BAN: Albuterol was mixed at a 1:1 ratio with NS. Ex: 0.5 albuterol was mixed with 0.5 NS. If Albuterol was combined with ipratroprium or budesonide, there was no difference in dilution between Misty and BAN. i.e. no NS added. Misty neb was nebulized until consistent sputter (8-12 minutes). BAN was nebulized to sputter or 5 minutes whichever came first (as per manufacturer instructions). Flow rates for both nebulizers were identical (6-8 lpm); no blow-by treatments were given in either group. Results: Breath Actuated Nebulizer: Number of Nebulizer Treatments: 5.8 Hours on Oxygen: 3.43 Length of Stay (LOS): 29.96 hours Misty Nebulizer Number of Nebulizer Treatments: 7.04 Hours on Oxygen: 7.5 Length of Stay (LOS): 34.5 hours Conclusions: Patients who received inhaled medication via BAN required fewer treatments, spent fewer hours on oxygen, and had an overall decreased LOS. Based upon these results, CHW elected to transition to the BAN for use in our asthmatic patients. Additional research should be performed to evaluate the effectiveness on other disease populations and additional medications. Sponsored Research - None Demographics and Results