Bronchodilator response with use of OptiVent versus Aerosol Cloud Enhancer metered-dose inhaler spacers in patients receiving ventilatory assistance.
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.
Waugh
J B
JB
Cardiopulmonary Care Sciences Department, Georgia State University, Atlanta, USA.
Jones
D F
DF
Aranson
R
R
Honig
E G
EG
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
D001993:Bronchodilator Agents; D000420:Albuterol