title: Inhalation therapy in mechanical ventilation.
abstract: Patients with obstructive lung disease often require ventilatory support via invasive or noninvasive mechanical ventilation, depending on the severity of the exacerbation. The use of inhaled bronchodilators can significantly reduce airway resistance, contributing to the improvement of respiratory mechanics and patient-ventilator synchrony. Although various studies have been published on this topic, little is known about the effectiveness of the bronchodilators routinely prescribed for patients on mechanical ventilation or about the deposition of those drugs throughout the lungs. The inhaled bronchodilators most commonly used in ICUs are beta adrenergic agonists and anticholinergics. Various factors might influence the effect of bronchodilators, including ventilation mode, position of the spacer in the circuit, tube size, formulation, drug dose, severity of the disease, and patient-ventilator synchrony. Knowledge of the pharmacological properties of bronchodilators and the appropriate techniques for their administration is fundamental to optimizing the treatment of these patients.
authors.affiliation: Hospital Moinhos de Vento, Porto Alegre, RS, Brasil.
authors.forename: Juçara Gasparetto
authors.initials: JG
authors.lastname: Maccari
authors.affiliation: Hospital Moinhos de Vento, Porto Alegre, RS, Brasil.
authors.forename: Cassiano
authors.initials: C
authors.lastname: Teixeira
authors.affiliation: Departamento de Pneumologia, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil.
authors.forename: Marcelo Basso
authors.initials: MB
authors.lastname: Gazzana
authors.affiliation: Hospital Moinhos de Vento, Porto Alegre, RS, Brasil.
authors.forename: Augusto
authors.initials: A
authors.lastname: Savi
authors.affiliation: Hospital Moinhos de Vento, Porto Alegre, RS, Brasil.
authors.forename: Felippe Leopoldo
authors.initials: FL
authors.lastname: Dexheimer-Neto
authors.affiliation: Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Marli Maria
authors.initials: MM
authors.lastname: Knorst
mesh_terms: D000280:Administration, Inhalation; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D008168:Lung / Q000187:drug effects; D008297:Male; D009330:Nebulizers and Vaporizers; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods*
chemical_list: D001993:Bronchodilator Agents