Abstract:
:Successful bronchodilator therapy with a metered-dose inhaler (MDI) in intubated, mechanically ventilated patients requires adequate delivery of aerosol to the lower respiratory tract. We determined the effect of ventilator mode, inspiratory flow pattern, humidity, and spontaneous respiratory effort on albuterol delivery in a model of the trachea and bronchi. The model was ventilated through an endotracheal tube during controlled mechanical ventilation (CMV), assist control (AC), pressure support (PS), and continuous positive airway pressure (CPAP), separately with a dry and humidified ventilator circuit. Delivery of albuterol administered by a MDI and spacer on filter placed at the ends of the bronchi was measured by spectrophotometry (246 nm). Under dry conditions and with a frequency of 10 breaths/min, albuterol delivery with CMV (VT, 800 ml; 30.3 +/- 3.4%), AC (VT, 800 ml; 31.9 +/- 1.3%), PS 10 cm H2O (VT, 700 ml; 28.8 +/- 4.5%), or PS 20 cm H2O (VT, 800 ml; 30.9 +/- 1.8%) was lower than that observed with simulated spontaneous breaths with CPAP (VT, 800 ml; 39.2 +/- 1.4%) (p < 0.01 for all modes). Delivery was greater under dry (28.8 to 39%) than under humidified conditions (15.9 to 20.2%) (p < 0.005 in all modes). Albuterol delivery showed a linear correlation with both inspiratory time and duty cycle (r > 0.91). Lower respiratory tract delivery of aerosol from a MDI varied from 4.9 to 39.2%. We conclude that in addition to other known factors such as dose, type of spacer, and its position the technique of administering MDIs in mechanically ventilated patients markedly influences lower respiratory tract aerosol delivery.
journal_name
Am J Respir Crit Care Medauthors
Fink JB,Dhand R,Duarte AG,Jenne JW,Tobin MJdoi
10.1164/ajrccm.154.2.8756810subject
Has Abstractpub_date
1996-08-01 00:00:00pages
382-7issue
2 Pt 1eissn
1073-449Xissn
1535-4970journal_volume
154pub_type
杂志文章abstract::In humans, respiratory viral infections lead to increased airway responsiveness and exacerbations of asthma. In the present study, the role of interleukin-5 (IL-5) in virus-induced airway hyperresponsiveness and inflammation was examined in guinea pigs. In animals treated with control antibody, parainfluenza-3 virus s...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.151.1.7812550
更新日期:1995-01-01 00:00:00
abstract::In this case-control family study of sleep-disordered breathing (SDB), we describe the distributions of SDB and SDB risk factors in African-Americans and Caucasians. A total of 225 African-Americans and 622 Caucasians, ages 2 to 86 yr, recruited as members of families with an individual with known sleep apnea (85 inde...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.155.1.9001310
更新日期:1997-01-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2004-10-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/rccm.200506-1006OC
更新日期:2006-08-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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更新日期:2000-09-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1164/ajrccm.155.4.9105070
更新日期:1997-04-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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更新日期:2011-10-15 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1164/rccm.201201-0058PP
更新日期:2012-07-15 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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更新日期:2001-08-15 00:00:00
abstract:RATIONALE:Donor mesenchymal stromal/stem cell (MSC) expansion and fibrotic differentiation is associated with development of bronchiolitis obliterans syndrome (BOS) in human lung allografts. However, the regulators of fibrotic differentiation of these resident mesenchymal cells are not well understood. OBJECTIVES:This...
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更新日期:2012-01-01 00:00:00
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更新日期:2018-05-15 00:00:00
abstract:RATIONALE:Implementation of intervention strategies to prevent lung damage in early cystic fibrosis (CF) requires objective outcome measures that capture and track lung disease. OBJECTIVES:To define the utility of the Lung Clearance Index (LCI), measured by multiple breath washout, as a means to track disease progress...
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pub_type: 杂志文章,多中心研究
doi:10.1164/rccm.201610-2158OC
更新日期:2017-05-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/rccm.200408-1046OC
更新日期:2005-02-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.150.3.8087350
更新日期:1994-09-01 00:00:00
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更新日期:2006-12-15 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1164/ajrccm.154.3.8810590
更新日期:1996-09-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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更新日期:2005-05-15 00:00:00
abstract:RATIONALE:The impact of asthma on chronic lung function deficits is well known. However, there has been little study of ethnic differences in these asthma-associated deficits. OBJECTIVES:To examine whether there are ethnic differences in the effects of asthma on children's lung function. METHODS:We evaluated the impa...
journal_title:American journal of respiratory and critical care medicine
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更新日期:2011-03-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:American journal of respiratory and critical care medicine
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
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更新日期:1997-01-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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更新日期:2010-10-15 00:00:00
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更新日期:2020-01-16 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章,随机对照试验
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更新日期:2008-06-15 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章
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更新日期:2014-09-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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更新日期:2013-10-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.149.4.8143050
更新日期:1994-04-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/rccm.200508-1271OC
更新日期:2006-06-15 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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更新日期:2008-08-15 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/rccm.200404-464OC
更新日期:2004-12-01 00:00:00