Inhaled bronchodilator administration during mechanical ventilation.
Inhaled bronchodilators are routinely administered to mechanically ventilated patients to relieve dyspnea and reverse bronchoconstriction. A lower percentage of the nominal dose reaches the lower respiratory tract in a mechanically ventilated patient than in a nonintubated subject, but attention to device selection, administration technique, dosing, and patient-ventilator interface can increase lower-respiratory-tract deposition in a mechanically ventilated patient. Assessing the airway response to bronchodilator by measuring airway resistance and intrinsic positive end-expiratory pressure helps guide dosing and timing of drug delivery. Selecting the optimal aerosol-generating device for a mechanically ventilated patient requires consideration of the ease, reliability, efficacy, safety, and cost of administration. With careful attention to administration technique, bronchodilator via metered-dose inhaler or nebulizer can be safe and effective with mechanically ventilated patients.
Duarte
Alexander G
AG
Division of Pulmonary and Critical Care Medicine, University of Texas Medical Branch, Galveston, TX 77555-0561, USA. aduarte@utmb.edu.
D000280:Administration, Inhalation; D000336:Aerosols; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000737:chemistry; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring / Q000379:methods; D004867:Equipment Design; D006361:Heating; D006801:Humans; D006813:Humidity; D007442:Intubation, Intratracheal / Q000295:instrumentation; D009330:Nebulizers and Vaporizers; D018579:Patient Selection; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000379:methods*
D000336:Aerosols; D001993:Bronchodilator Agents