Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Critical Care
Erschienen in: Critical Care 4/2000

01.08.2000 | Review

Bronchodilator delivery with metered-dose inhaler during mechanical ventilation

verfasst von: Dimitris Georgopoulos, Eleni Mouloudi, Eumorfia Kondili, Maria Klimathianaki

Erschienen in: Critical Care | Ausgabe 4/2000

Einloggen, um Zugang zu erhalten

Abstract

The delivery of bronchodilators with metered-dose inhaler (MDI) in mechanically ventilated patients has attracted considerable interest in recent years. This is because the use of the MDI has several advantages over the nebulizer, such as reduced cost, ease of administration, less personnel time, reliability of dosing and a lower risk of contamination. A spacer device is fundamental in order to demonstrate the efficacy of the bronchodilatory therapy delivered by MDI. Provided that the technique of administration is appropriate, MDIs are as effective as nebulizers, despite a significantly lower dose of bronchodilator given by the MDI.
Literatur
1.
Boucher BA, Kuhl DA, Coffey BC, Fabian TC: Drug use in a trauma intensive care unit. Am J Hosp Pharm 1990, 47: 805-810.PubMed
2.
Dhand R, Tobin MJ: Inhaled bronchodilator therapy in mechanically ventilated patients. Am J Respir Crit Care Med 1997, 156: 3-10.CrossRefPubMed
3.
Dhand R, Tobin MJ: Bronhodilator delivery with metered-dose inhalers in mechanically-ventilated patients. Eur Respir J 1996, 9: 585-595. 10.1183/09031936.96.09030585CrossRefPubMed
4.
Wright PE, Carmichael LC, Bernard GR: Effect of bronchodilators on lung mechanics in the acute respiratory distress syndrome (ARDS). Chest 1994, 106: 1517-1523.CrossRefPubMed
5.
Georgopoulos D, Brochard L: Ventilatory strategies in acute exacerbations of chronic obstructive pulmonary disease. Eur Respir Monit 1998, 8: 12-44.
6.
Georgopoulos D, Burchardi H: Ventilatory strategies in adult patients with status asthmaticus. Eur Respir Monit 1998, 8: 45-83.
7.
Summer W, Elston R, Tharpe L, Nelson S, Haponic EF: Aerosol bronchodilator delivery methods: relative impact on pulmonary function and cost of respiratory care. Arch Intern Mer 1989, 149: 618-623. 10.1001/archinte.149.3.618CrossRef
8.
Bowton DL, Goldsmoth WM, Haponic EF: Substitution of metered-dose inhalers for hand nebulizers: success and cost-saving in a large, acute care hospital. Chest 1998, 101: 305-308.CrossRef
9.
Alvine GF, Rodgers P, Fitzsimmons KM, Ahrens RC: Disposable jet nebulizers; how reliable are they? Chest 1992, 101: 316-319.CrossRefPubMed
10.
Hamill RJ, Houston ED, Georghiu PR, Wright CE, Koza MA, Cadle RM, Goeptert PA, Lewis DA, Zenon GJ, Clarridge JE: An outbreak of Burkholderia (formerly Pseudomonas ) cepacia respiratory track colonisation and infection associated with nebulized albuterol therapy. Ann Intern Med 1995, 122: 762-766.CrossRefPubMed
11.
Beaty CD, Ritz Rh, Benson Ms: Continuous in-line nebulizers complicate pressure support ventilation. Chest 1989, 96: 1360-1363.CrossRefPubMed
12.
Hess D: Aerosol bronchodilator delivery during mechanical ventilation nebulizer or inhaler? Chest 1991, 100: 1103-1104.CrossRefPubMed
13.
Manthous CA, Hall JB, Schmidt GA, Wood LD: Metered-dose inhaler versus nebulized albuterol in mechanically ventilated patients. Am Rev Respir Dis 1993, 148: 1567-1570.CrossRefPubMed
14.
Fink JB, Dhand R, Duarte AG, Jenne JW, Tobin MJ: Deposition of aerosol from metered-dose inhaler during mechanical ventilation: an in vitro model. Am J Respir Crit Care Med 1996, 154: 382-387.CrossRefPubMed
15.
Crogan SJ, Bishop MJ: Delivery efficiency of metered-dose aerosols given via endotracheal tube. Anesthesiology 1989, 70: 1008-1010.CrossRefPubMed
16.
Fuller HD, Dolovich MB, Postmituck G, Wong Pack W, Newhouse MT: Pressurized aerosol versus jet aerosol delivery to mechanically-ventilated patients: comparison of dose to the lungs. Am Rev Respir Dis 1990, 141: 440-444.CrossRefPubMed
17.
Ebert J, Adams AB, Green-Eide B: An evaluation of MDI spacers and adapters: their effect on the respirable volume of medication. Respir Care 1992, 37: 862-868.PubMed
18.
Fuller HD, Dolovich MB, Chambers C, Newhouse MT: Aerosol delivery during mechanical ventilation: a predictive in vitro model. J Aerosol Med 1992, 5: 251-259.CrossRef
19.
Fink JB, Dhand R, Grychowski J, Fahey PJ, Tobin MJ: Reconciling in vitro measurements of aerosol delivery from a metered-dose inhaler during mechanical ventilation and defining efficiency enhancing factors. Am J Respir Crit Care Med 1999, 159: 63-68.CrossRefPubMed
20.
Diot P, Morra L, Smaldone GC: Albuterol delivery in a model of mechanical ventilation: comparison of metered-dose inhaler and nebulizer efficiency. Am J Respir Crit Care Med 1995, 152: 1391-1394.CrossRefPubMed
21.
Rau JL, Harwood RJ, Groff JL: Evaluation of a reservoir devise for metered dose bronchodilator delivery to intubated adults: an in vitro study. Chest 1992, 102: 924-930.CrossRefPubMed
22.
Fuller HD, Dolovich MB, Turpie FH, Newhouse MT: Efficiency of bronchodilator aerosol delivery to the lungs from the metered dose inhaler in mechanically ventilated patients: a study comparing four different actuator devices. Chest 1994, 105: 214-218.CrossRefPubMed
23.
Fok TF, al-Essa M, Monkman S, Dolovich M, Girard L, Coates G, Kirpalani H: Delivery of metered dose inhaler aerosols to paralyzed and nonparalyzed rabbits. Crit Care Med 1997, 25: 140-144. 10.1097/00003246-199701000-00026CrossRefPubMed
24.
Marik P, Hogan J, Krikorian J: A comparison of bronchodilator therapy delivered by nebulization and metered-dose inhaler in mechanically ventilated patients. Chest 1999, 115: 1653-1657. 10.1378/chest.115.6.1653CrossRefPubMed
25.
Duarte AG, Dhand R, Ralston R, Fink J, Fahey P, Tobin MJ, Jenne JW: Serum albuterol levels in mechanically ventilated patients and healthy subjects after metered-dose inhaler administration. Am J Respir Crit Care Med 1996, 154: 1658-1663.CrossRefPubMed
26.
Gottfried SB, Rossi A, Higgs BD, Zocchi L, Grassino A, Milic-Emili J: Respiratory mechanics in mechanically ventilated patients with respiratory failure. J Appl Physiol 1985, 58: 1849-1858.PubMed
27.
Bates JHT, Rossi A, Milic-Emili J: Analysis of the behaviour of the respiratory mechanics in mechanically ventilated patients with respiratory failure. J Appl Physiol 1985, 58: 1840-1848.PubMed
28.
Tuxen DV, Lane S: The effects of ventilatory pattern on hyperinflation, airway pressures and circulation in mechanical ventilation of patients with severe air-flow obstruction. Am Rev Respir Dis 1987, 136: 872-879.CrossRefPubMed
29.
Georgopoulos D, Giannouli E, Patakas D: Effects of extrinsic positive end-expiratory pressure on mechanically ventilated patients with chronic obstructive pulmonary disease and dynamic hyperinflation. Intensive Care Med 1993, 19: 197-203.CrossRefPubMed
30.
Dawson SV, Elliott EA: Wave-speed limitation on expiratory flow-a unifying concept. Am Rev Respir Dis 1997, 140: 1-3.
31.
Gay PC, Patel HG, Nelson SB, Gilles B, Hubmayr RD: Metered dose inhalers for bronchodilator delivery in intubated, mechanically ventilated patients. Chest 1991, 99: 66-71.CrossRefPubMed
32.
Georgopoulos D, Mitrouska I, Markopoulou K, Patakas D, Anthonisen NR: Effects of breathing pattern on mechanically ventilated patients with chronic obstructive pulmonary disease and dynamic hyperinflation. Intensive Care Med 1995, 21: 880-886.CrossRefPubMed
33.
Tobin MJ: Monitoring respiratory mechanics in spontaneously breathing patients. In: Principles and Practice of Intensive Care Monitoring. Edited by Tobin MJ. New York: McGraw-Hill, Incorporated, Health Professions Division, 1998, 617-654.
34.
Mancebo J, Amaro P, Lorino H, Lemaire F, Harf A, Brochard L: Effects of albuterol inhalation on the work of breathing during weaning from mechanical ventilation. Am Rev Respir Dis 1991, 144: 95-100.CrossRefPubMed
35.
Mead J, Lindgren I, Gaensler AE: The mechanical properties of the lungs in emphysema. J Clin Invest 1956, 34: 1005-1016.CrossRef
36.
Fernandez A, Lazaro A, Garcia A, Aragon C, Cerda E: Bronchodilators in patients with obstructive pulmonary disease on mechanical ventilation: utilisation of metered-dose inhalers. Am Rev Respir Dis 1990, 141: 164-168.CrossRefPubMed
37.
Dhand R, Jubran A, Tobic MT: Bronchodilator delivery by metered-dose inhaler in ventilator support patients. Am J Respir Crit Care Med 1995, 151: 1827-1833.CrossRefPubMed
38.
Dhand R, Duarte AG, Jubran A, Jenne JW, Fink JB, Fahey PJ, Tobin MJ: Dose-response to bronchodilator delivered by metered dose inhaler in ventilator-support patients. Am J Respir Crit Care Med 1996, 154: 388-393.CrossRefPubMed
39.
Mouloudi E, Katsanoulas K, Anastasaki M, Askitopoulou E, Georgopoulos D: Bronchodilator delivery by metered-dose inhaler in mechanically ventilated COPD patients: influence of end-inspiratory pause. Eur Respir J 1998, 12: 165-169. 10.1183/09031936.98.12010165CrossRefPubMed
40.
Mouloudi E, Katsanoulas K, Anastasaki M, Hoing S, Georgopoulos D: Bronchodilator delivery by metered-dose inhaler in mechanically ventilated COPD patients: influence of tidal volume. Intensive Care Med 1999, 25: 1215-1221. 10.1007/s001340051049CrossRefPubMed
41.
Mouloudi E, Prinianakis G, Kondili E, Georgopoulos D: Bronchodilator delivery by metered-dose inhaler in mechanically ventilated COPD patients: influence of flow pattern. Eur Respir J 2000, in press.
42.
Guerin G, Chevre A, Dessirier P, Poncet T, Becquemin MH, Dequin PF, Le Guellec C, Jacques D: Inhaled fenoterol-ipratropium bromide in mechanically ventilated patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1999, 159: 1036-1042.CrossRefPubMed
43.
Mouloudi E, Katsanoulas K, Hoing S, Prinianakis G, Zeaki M, Georgopoulos D: Duration of effect of bronchodilator delivered by metered dose inhaler in mechanically ventilated COPD patients. Intensive Care Med 1999, 25(Suppl 1): S129.
Metadaten
Titel
Bronchodilator delivery with metered-dose inhaler during mechanical ventilation
verfasst von
Dimitris Georgopoulos
Eleni Mouloudi
Eumorfia Kondili
Maria Klimathianaki
Publikationsdatum
01.08.2000
Verlag
BioMed Central
Erschienen in
Critical Care / Ausgabe 4/2000
Elektronische ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc698

Weitere Artikel der Ausgabe 4/2000

Critical Care 4/2000 Zur Ausgabe

Commentary

Tonometry of partial carbon dioxide tension in gastric mucosa: use of saline, buffer solutions, gastric juice or air

Commentary

Paper reports overview: First do no harm: the aftermath of intensive care

Review

Instruments for monitoring intensive care unit sedation

Research

A case of central nervous system vasculitis related to an episode of Guillain-Barrè syndrome

Review

Carbon dioxide kinetics and capnography during critical care

Commentary

Toward a better ventilation strategy for patients with acute lung injury

Neu im Fachgebiet AINS

Tipps für den Umgang mit Behandlungsfehlern

01.05.2024 DGIM 2024 Kongressbericht

Es ist nur eine Frage der Zeit, bis es zu einem Zwischenfall kommt und ein Behandlungsfehler passiert. Doch wenn Ärztinnen und Ärzte gut vorbereitet sind, schaffen es alle Beteiligten den Umständen entsprechend gut durch diese Krise. 

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

hier abonnieren
Bildnachweise