title: Bronchodilator response with use of OptiVent versus Aerosol Cloud Enhancer metered-dose inhaler spacers in patients receiving ventilatory assistance.
abstract: OBJECTIVE
  This study compared the clinical effectiveness of the OptiVent (HealthScan Products, Inc, Cedar Grove, NJ) and the ACE (DHD, Inc, Canastota, NY) metered dose inhaler (MDI) in-line spacers.
  
  
  METHODS
  Two-group, split-plot design with subjects serving as their own controls.
  
  
  METHODS
  Data were collected in a 1000-bed urban hospital.
  
  
  METHODS
  A convenience sample of 7 intubated patients receiving mechanical ventilation.
  
  
  METHODS
  Patients received 4 and 8 puffs of albuterol with use of both the OptiVent and ACE devices.
  
  
  RESULTS
  Changes in expiratory airway resistance (Raw), passive peak expiratory flow rate (PEFR), and total work-of-breathing (WOBTOT) were determined using a Bicore monitor (Bicore Monitoring System; Irvine, Calif). With the ACE, Raw decreased an average of 20.2% and 8.8% in patients receiving 4 and 8 puffs, respectively. With the OptiVent, Raw decreased an average of 34.6% and 10.8% in patients receiving 4 and 8 puffs, respectively. Improvements in WOBTOT were less than those seen in Raw, and PEFR did not trend with the other 2 variables. The performances of the 2 spacer brands were comparable, with no statistical difference (P values > 0.05) for all 3 variables with use of the nonparametric Kolmogorov-Smirnov test.
  
  
  CONCLUSIONS
  These data suggest that use of the OptiVent spacer yields comparable clinical results with the ACE spacer in patients receiving mechanical ventilation and merits further evaluation.
authors.affiliation: Cardiopulmonary Care Sciences Department, Georgia State University, Atlanta, USA.
authors.forename: J B
authors.initials: JB
authors.lastname: Waugh
authors.forename: D F
authors.initials: DF
authors.lastname: Jones
authors.forename: R
authors.initials: R
authors.lastname: Aranson
authors.forename: E G
authors.initials: EG
authors.lastname: Honig
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000628:therapy*; D000420:Albuterol / Q000008:administration & dosage*; D001980:Bronchi / Q000187:drug effects; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000379:methods; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D000420:Albuterol