High-efficiency delivery of salbutamol with a metered-dose inhaler in narrow tracheal tubes and catheters.

Abstract:

:We sought to determine the percent delivery by metered-dose inhaler (MDI) of a preparation of salbutamol (albuterol) to the distal end of either pediatric-size tracheal tubes or a narrow-gauge catheter. A bench model consisting of a swivel actuator; 3.0-6.0-mm ID tracheal tubes all 16 cm in length or a 19-G (standard wire gauge) catheter; mesh filters; and a continuous flow of dry air was used. Six actuations of salbutamol (100 micrograms each) were delivered during each experiment, and each experiment was repeated nine times. The delivery efficiency (DE) was the ratio of the net increase in weight of the filter, positioned at the distal end of the tracheal tube, to the net weight increase of the entire apparatus. We found that the DE (mean +/- SD) of salbutamol at the end of the tracheal tube was significantly less with a 3.0-mm ID tube (2.5 +/- 7.0%) than it was with a 4.0-mm (10.8 +/- 8.3%), 5.0-mm (10.7 +/- 7.2%), or 6.0-mm (12.3 +/- 8.4%) tube (P less than 0.05). To improve the DE of salbutamol aerosol, a 19-G catheter (0.7 mm ID) was inserted through the elbow connector and passed down the tracheal tube until the tip of the catheter approximated the distal tip of the tube. The DE of salbutamol in tracheal tubes (less than or equal to 12.3%) increased dramatically (97%; P less than 0.001) when a 19-G catheter was used. We conclude that the DE of salbutamol by MDI through 3.0-6.0-mm ID tracheal tubes is low but may be dramatically increased by actuating the canister into a 19-G distally placed catheter. Because of the increased efficiency of delivery, caution must be exercised when using a distally placed catheter to deliver MDI aerosols to patients.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Taylor RH,Lerman J

doi

10.1097/00000542-199102000-00024

subject

Has Abstract

pub_date

1991-02-01 00:00:00

pages

360-3

issue

2

eissn

0003-3022

issn

1528-1175

journal_volume

74

pub_type

杂志文章
  • Isoflurane causes endothelium-dependent inhibition of contractile responses of canine coronary arteries.

    abstract::The authors sought to determine if isoflurane would attenuate effects of three different types of vasoconstrictors on isolated segments of canine epicardial coronary arteries removed from healthy dogs. As the endothelium has a major role in regulating epicardial coronary artery tone, and as it modulates the effect of ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198710000-00012

    authors: Blaise G,Sill JC,Nugent M,Van Dyke RA,Vanhoutte PM

    更新日期:1987-10-01 00:00:00

  • Inhaled anesthetics alter the determinants of coronary collateral blood flow in the dog.

    abstract:BACKGROUND:Whether coronary steal is induced by inhaled anesthetic agents remains controversial in part because multiple factors determine collateral blood flow. METHODS:We used an established model to determine how halothane, isoflurane, and desflurane affect the hemodynamic determinants of coronary collateral blood ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199510000-00020

    authors: Mignella R,Buffington CW

    更新日期:1995-10-01 00:00:00

  • Diagnosis of ventilator-associated pneumonia: an evaluation of direct examination and presence of intracellular organisms.

    abstract:BACKGROUND:Ventilator-associated pneumonia (VAP) requires early diagnosis and adequate antibiotic therapy. The aim of this prospective postmortem study was to assess the accuracy of direct examination and quantification of intracellular organisms (ICO) for the diagnosis of VAP. METHODS:Total and differential cell coun...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199708000-00013

    authors: Papazian L,Autillo-Touati A,Thomas P,Bregeon F,Garbe L,Saux P,Seite R,Gouin F

    更新日期:1997-08-01 00:00:00

  • Performance of anesthetic depth indexes in rabbits under propofol anesthesia: prediction probabilities and concentration-effect relations.

    abstract:BACKGROUND:The permutation entropy, the approximate entropy, and the index of consciousness are some of the most recently studied electroencephalogram-derived indexes. In this work, a thorough comparison of these indexes was performed using propofol anesthesia in a rabbit model. METHODS:Six rabbits were anesthetized w...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e318222ac02

    authors: Silva A,Campos S,Monteiro J,Venâncio C,Costa B,Guedes de Pinho P,Antunes L

    更新日期:2011-08-01 00:00:00

  • Effects of intravenous general anesthetics on [3H]GABA release from rat cortical synaptosomes.

    abstract:BACKGROUND:Potentiation by general anesthetics of gamma-aminobutyric acid (GABA)-mediated inhibitory transmission in the central nervous system is attributed to GABA(A) receptor-mediated postsynaptic effects. However, the role of presynaptic mechanisms in general anesthetic action is not well characterized, and evidenc...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199810000-00017

    authors: Murugaiah KD,Hemmings HC Jr

    更新日期:1998-10-01 00:00:00

  • Lack of nonshivering thermogenesis in infants anesthetized with fentanyl and propofol.

    abstract:BACKGROUND:Sweating, vasoconstriction, and shivering have been observed during general anesthesia. Among these, vasoconstriction is especially important because-once triggered-it minimizes further hypothermia. Surprisingly, the core-temperature plateau associated with vasoconstriction appears to preserve core temperatu...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199704000-00006

    authors: Plattner O,Semsroth M,Sessler DI,Papousek A,Klasen C,Wagner O

    更新日期:1997-04-01 00:00:00

  • Concentration-effect relationship of cisatracurium at three different dose levels in the anesthetized patient.

    abstract:BACKGROUND:The linearity of cisatracurium elimination and its concentration-effect relation were determined as part of a traditional rich data study with three dose levels in patients receiving balanced anesthesia. METHODS:Forty-eight adults with American Society of Anesthesiologists status I-II were randomized to rec...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200108000-00010

    authors: Bergeron L,Bevan DR,Berrill A,Kahwaji R,Varin F

    更新日期:2001-08-01 00:00:00

  • Acute normovolemic hemodilution in the pig is associated with renal tissue edema, impaired renal microvascular oxygenation, and functional loss.

    abstract:BACKGROUND:The authors investigated the impact of acute normovolemic hemodilution (ANH) on intrarenal oxygenation and its functional short-term consequences in pigs. METHODS:Renal microvascular oxygenation (µPO2) was measured in cortex, outer and inner medulla via three implanted optical fibers by oxygen-dependent que...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e31829bd9bc

    authors: Konrad FM,Mik EG,Bodmer SI,Ates NB,Willems HF,Klingel K,de Geus HR,Stolker RJ,Johannes T

    更新日期:2013-08-01 00:00:00

  • Effect of increased intracranial pressure on regional hypoxic pulmonary vasoconstriction.

    abstract::The effects of increased intracranial pressure (ICP) and increased cardiac output (QT) on the pulmonary vascular response to regional alveolar hypoxia were compared in pentobarbital-anesthetized, closed-chested dogs. A bronchial divider was inserted, the right lung (RL) was continuously ventilated with 100% O2, and th...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199003000-00017

    authors: Domino KB,Hlastala MP,Cheney FW

    更新日期:1990-03-01 00:00:00

  • Acute opioid tolerance: intraoperative remifentanil increases postoperative pain and morphine requirement.

    abstract:BACKGROUND:Rapid development of acute opioid tolerance is well established in animals and is more likely to occur with large doses of short-acting drugs. The authors therefore tested the hypothesis that intraoperative remifentanil administration results in acute opioid tolerance that is manifested by increased postoper...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200008000-00019

    authors: Guignard B,Bossard AE,Coste C,Sessler DI,Lebrault C,Alfonsi P,Fletcher D,Chauvin M

    更新日期:2000-08-01 00:00:00

  • Inferior Vena Cava Ultrasonography before General Anesthesia Can Predict Hypotension after Induction.

    abstract:BACKGROUND:Hypotension is a common side effect of general anesthesia induction, and when severe, it is related to adverse outcomes. Ultrasonography of inferior vena cava (IVC) is a reliable indicator of intravascular volume status. This study investigated whether preoperative ultrasound IVC measurements could predict h...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000001002

    authors: Zhang J,Critchley LA

    更新日期:2016-03-01 00:00:00

  • Studies on the safety of chronically administered intrathecal neostigmine methylsulfate in rats and dogs.

    abstract:BACKGROUND:The spinal delivery of the cholinesterase inhibitor neostigmine yields analgesia in rats and augments the analgesic effects of alpha 2 agonists in sheep. To assess its activity in humans, preclinical toxicology studies to define its safety were required in two species. METHODS:Rats with chronic intrathecal ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199502000-00012

    authors: Yaksh TL,Grafe MR,Malkmus S,Rathbun ML,Eisenach JC

    更新日期:1995-02-01 00:00:00

  • Postoperative hyperoxia (60%) worsens hepatic injury in mice.

    abstract:BACKGROUND:Liver damage by ischemia and reperfusion injury is a risk factor for morbidity and mortality after liver surgery. Postoperative oxygen treatment is routinely applied in the postanesthesia and intensive care unit after liver surgery. The risks of aggravating the injury by increasing inspiratory oxygen from 21...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000447

    authors: Zangl Q,Martignoni A,Jackson SH,Ohta A,Klaunberg B,Kaufmann I,Lukashev D,Ward JM,Sitkovsky M,Thiel M,Choukèr A

    更新日期:2014-12-01 00:00:00

  • Effects of intrathecally administered lamotrigine, a glutamate release inhibitor, on short- and long-term models of hyperalgesia in rats.

    abstract:BACKGROUND:Lamotrigine is a sodium channel blocker that inhibits the neuronal release of glutamate. Systemic administration of lamotrigine induces analgesia in short- and long-term models of hyperalgesia in rats. Considering the key role of N-methyl-D-aspartate receptors in the sensitization of dorsal horn neurons that...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199802000-00028

    authors: Klamt JG

    更新日期:1998-02-01 00:00:00

  • Analgesic effects of gabapentin after spinal surgery.

    abstract:BACKGROUND:A combination of opioid and nonopioid analgesic drugs may improve the quality of postoperative analgesia as well as reduce opioid requirements and their associated side effects. Studies have shown synergism between gabapentin and morphine in animal and human experiments and in the treatment of incisional pai...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200404000-00025

    authors: Turan A,Karamanlioğlu B,Memiş D,Hamamcioglu MK,Tükenmez B,Pamukçu Z,Kurt I

    更新日期:2004-04-01 00:00:00

  • Cerebral blood flow and metabolism in dogs with chronic diabetes.

    abstract:BACKGROUND:Previously, the authors found that anesthetized diabetic dogs had increased cerebral blood flow (CBF) and oxygen consumption (CMRO2). These results may have been influenced by anesthesia or surgery. The aim of this study was to determine whether CBF and CMRO2 are increased in the awake or anesthetized state ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199311000-00020

    authors: Sieber FE,Brown PR,Wu Y,Koehler RC,Traystman RJ

    更新日期:1993-11-01 00:00:00

  • Intrathecal opioids and lower urinary tract function: a urodynamic evaluation.

    abstract:BACKGROUND:Intrathecal administration of opioids may cause lower urinary tract dysfunction. In this study, the authors compared the effects of morphine and sufentanil administered intrathecally in a randomized double-blind fashion (two doses each) on lower urinary tract function in healthy male volunteers. METHODS:Uro...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200406000-00023

    authors: Kuipers PW,Kamphuis ET,van Venrooij GE,van Roy JP,Ionescu TI,Knape JT,Kalkman CJ

    更新日期:2004-06-01 00:00:00

  • Pronociceptive effects of remifentanil in a mouse model of postsurgical pain: effect of a second surgery.

    abstract:BACKGROUND:Remifentanil anesthesia enhances postoperative pain in animals and humans. The authors evaluated the impact of the dose (microg x kg(-1) x min(-1)) and duration of remifentanil infusion, and the effects of a second surgery on postoperative pain sensitization. METHODS:Mice received different doses of remifen...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e3181bfab61

    authors: Cabañero D,Campillo A,Célérier E,Romero A,Puig MM

    更新日期:2009-12-01 00:00:00

  • Mortality experience among anesthesiologists, 1954-1976.

    abstract::To determine whether anesthesiologists, because of prolonged exposure to halothane or other inhalational anesthetics, might have higher death rates from all causes, from cancer, and from hepatic or renal disease than other physicians, the mortality rates of male and female members of the American Society of Anesthesio...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197909000-00003

    authors: Lew EA

    更新日期:1979-09-01 00:00:00

  • Site of origin of halothane--epinephrine arrhythmia determined by direct and echocardiographic recordings.

    abstract::A constantly coupled bigeminal arrhythmia was induced in dogs anesthetized with thiopental-halothane by infusion of epinephrine (1 microgram.kg-1.min-1). The site of origin of the abnormal beat was localized to the interventricular septum by bipolar recordings from the left and right ventricular epicardium and two sit...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198208000-00006

    authors: Smith ER,Dresel PE

    更新日期:1982-08-01 00:00:00

  • Effects of halothane, propofol, and thiopental on peripheral airway reactivity.

    abstract:BACKGROUND:General anesthetics modify airway responsiveness by several mechanisms, including direct effects on airway smooth muscle and reductions in neural reflex activity. Halothane has been shown to reduce responsiveness through both of these mechanisms. The airway effects of barbiturates are controversial, and the ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199308000-00014

    authors: Mehr EH,Lindeman KS

    更新日期:1993-08-01 00:00:00

  • Psychedelic effects of ketamine in healthy volunteers: relationship to steady-state plasma concentrations.

    abstract:BACKGROUND:Ketamine has been associated with a unique spectrum of subjective "psychedelic" effects in patients emerging from anesthesia. This study quantified these effects of ketamine and related them to steady-state plasma concentrations. METHODS:Ketamine or saline was administered in a single-blinded crossover prot...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199801000-00015

    authors: Bowdle TA,Radant AD,Cowley DS,Kharasch ED,Strassman RJ,Roy-Byrne PP

    更新日期:1998-01-01 00:00:00

  • Hemodynamic responses to mechanical ventilation with PEEP: the effect of hypervolemia.

    abstract::The hemodynamic effects of prolonged mechanical ventilation with positive end-expiratory pressure (PEEP), with and without blood volume augmentation, were studied in 18 beagles anesthetized with halothane (0.7 per cent end-tidal). Addition of 12 cm H2O PEEP during mechanical ventilation in normavolemic dogs was associ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197501000-00009

    authors: Qvist J,Pontoppidan H,Wilson RS,Lowenstein E,Laver MB

    更新日期:1975-01-01 00:00:00

  • Hyperinsulinemic Normoglycemia Does Not Meaningfully Improve Myocardial Performance during Cardiac Surgery: A Randomized Trial.

    abstract:BACKGROUND:Glucose-insulin-potassium (GIK) administration during cardiac surgery inconsistently improves myocardial function, perhaps because hyperglycemia negates the beneficial effects of GIK. The hyperinsulinemic normoglycemic clamp (HNC) technique may better enhance the myocardial benefits of GIK. The authors exten...

    journal_title:Anesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/ALN.0000000000000723

    authors: Duncan AE,Kateby Kashy B,Sarwar S,Singh A,Stenina-Adognravi O,Christoffersen S,Alfirevic A,Sale S,Yang D,Thomas JD,Gillinov M,Sessler DI

    更新日期:2015-08-01 00:00:00

  • Automated echocardiographic analysis. Examination of serial intraoperative measurements.

    abstract:BACKGROUND:Although transesophageal echocardiography allows continuous intraoperative cardiac monitoring, the technique has been limited by the lack of a method for realtime, quantitative assessment of cardiac chamber size and systolic function. Automated border detection (ABD), based on an analysis of integrated backs...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199508000-00008

    authors: Perrino AC Jr,Luther MA,O'Connor TZ,Cohen IS

    更新日期:1995-08-01 00:00:00

  • "Gentlemen! This Is No Humbug": Did John Collins Warren, M.D., Proclaim These Words on October 16, 1846, at Massachusetts General Hospital, Boston?

    abstract::The proclamation, "Gentlemen! this is no humbug," attributed to John Collins Warren, M.D., was not identified in any contemporaneous eyewitness report of William T. G. Morton's October 16, 1846, demonstration of ether at Massachusetts General Hospital. The earliest known documentation of the proclamation is in Nathan ...

    journal_title:Anesthesiology

    pub_type: 传,历史文章,杂志文章

    doi:10.1097/ALN.0000000000000944

    authors: Haridas RP

    更新日期:2016-03-01 00:00:00

  • Anesthetic techniques for fetal surgery: effects of maternal anesthesia on intraoperative fetal outcomes in a sheep model.

    abstract:BACKGROUND:Use of high-dose inhalational anesthesia during open fetal surgery may induce maternal-fetal hemodynamic instability and fetal myocardial depression. The authors' preliminary human retrospective study demonstrated less fetal bradycardia and left ventricular systolic dysfunction with lower dose desflurane sup...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e318283c954

    authors: Ngamprasertwong P,Michelfelder EC,Arbabi S,Choi YS,Statile C,Ding L,Boat A,Eghtesady P,Holland K,Sadhasivam S

    更新日期:2013-04-01 00:00:00

  • Discharge Readiness after Tricompartment Knee Arthroplasty: Adductor Canal versus Femoral Continuous Nerve Blocks-A Dual-center, Randomized Trial.

    abstract:BACKGROUND:The authors conducted a randomized, controlled, parallel-arm, superiority study to test the hypothesis that a continuous adductor canal block decreases the time to attain four discharge criteria compared with a continuous femoral nerve block after tricompartment knee arthroplasty. METHODS:Subjects undergoin...

    journal_title:Anesthesiology

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/ALN.0000000000000741

    authors: Machi AT,Sztain JF,Kormylo NJ,Madison SJ,Abramson WB,Monahan AM,Khatibi B,Ball ST,Gonzales FB,Sessler DI,Mascha EJ,You J,Nakanote KA,Ilfeld BM

    更新日期:2015-08-01 00:00:00

  • Pharmacokinetic-pharmacodynamic modeling of the respiratory depressant effect of alfentanil.

    abstract:BACKGROUND:Although respiratory depression is the most well-known and dangerous side effect of opioids, no pharmacokinetic-pharmacodynamic model exists for its quantitative analysis. The development of such a model was the aim of this study. METHODS:After institutional approval approval and informed consent were obtai...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199907000-00023

    authors: Bouillon T,Schmidt C,Garstka G,Heimbach D,Stafforst D,Schwilden H,Hoeft A

    更新日期:1999-07-01 00:00:00

  • Molecular mechanisms of opioid receptor-dependent signaling and behavior.

    abstract::Opioid receptors have been targeted for the treatment of pain and related disorders for thousands of years and remain the most widely used analgesics in the clinic. Mu (μ), kappa (κ), and delta (δ) opioid receptors represent the originally classified receptor subtypes, with opioid receptor like-1 (ORL1) being the leas...

    journal_title:Anesthesiology

    pub_type: 杂志文章,评审

    doi:10.1097/ALN.0b013e318238bba6

    authors: Al-Hasani R,Bruchas MR

    更新日期:2011-12-01 00:00:00