title: beta(2)-Agonist delivery via a resuscitator bag (Ambu MediBag): a comparison with a metered-dose inhaler using the Volumatic-Spacer.
abstract: Although the administration of beta(2)-agonists by inhalation is recommended in the current guidelines for treatment of patients with acute bronchospasm, the large volume spacer that is necessary often is not available on board an ambulance due to space storage problems. Accordingly, an adapter enabling the application of therapeutic aerosols from a metered-dose inhaler (MDI) via a resuscitator bag (Ambu MediBag) was developed. The aim of this double-blinded, randomised study was to test the clinical efficiency of the Ambu MediBag (volume: approximately 1500 ml) in comparison with the commonly used Volumatic-Spacer (volume: 750 ml). One hundred patients receiving a bronchodilator response test were treated with MDIs of either 200 microg salbutamol via the Volumatic-Spacer or 400 microg salbutamol via the Ambu MediBag. The change of lung function variables was measured by bodyplethysmography before and after drug application. In both groups of 50 patients each, a highly significant reduction of airway resistance was shown after treatment. However, there was no statistically significant difference in lung function variables between the Ambu MediBag and the Volumatic-Spacer. From these results, we conclude that the Ambu MediBag is as effective as Volumatic-Spacer and might improve preclinical and clinical treatment of acute bronchospasm by inhalation with bronchodilators.
authors.affiliation: Department of Anaesthesiology II-OE 8060, Medizinische Hochschule Hannover, Podbielskistr. 380, D-30659 Hannover, Germany. schleufe.petra@gmx.de
authors.forename: Petra
authors.initials: P
authors.lastname: Schleufe
authors.forename: Henning
authors.initials: H
authors.lastname: Domurath
authors.forename: Siegfried
authors.initials: S
authors.lastname: Piepenbrock
mesh_terms: D000208:Acute Disease; D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D000403:Airway Resistance; D000420:Albuterol / Q000008:administration & dosage; D001985:Bronchial Provocation Tests; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D036501:Metered Dose Inhalers; D008875:Middle Aged; D012151:Resuscitation / Q000295:instrumentation*; D013147:Spirometry
chemical_list: D000318:Adrenergic beta-Agonists; D000420:Albuterol