Aerosol bronchodilator delivery methods. Relative impact on pulmonary function and cost of respiratory care

Bronchodilator delivery with metered-dose inhalers in mechanically-ventilated patients

“…Use of MDIs for bronchodilator therapy instead of nebulizers results in substantial cost savings [66]. BOWTON et al [67] found that substitution of nebulizers by MDIs in a 700 bed hospital could decrease potential patient costs of aerosol therapy by $300,000 a year.…”

Effect of inspiratory flow rate on β2-agonist induced bronchodilation in mechanically ventilated COPD patients

“…The use of MDI has several advantages over the nebulizer, such as reduced cost, ease of administration, less personnel time, reliability of dosing, lower drug dose, and reduced risk of contamination [3,4,5,6,7].…”

“…The use of MDI has several advantages over the nebulizer, such as reduced cost, ease of administration, less personnel time, reliability of dosing, lower drug dose, and reduced risk of contamination [3,4,5,6,7].The technique of administering bronchodilators in mechanically ventilated patients using an MDI and a spacer is an important factor in determining the efficacy of this therapy. The timing of drug delivery and the ventilator settings during the administration have been reported to affect drug delivery to target sites and thus bronchodilation [1,2,8,9,10].…”

Bronchodilator delivery by metered-dose inhaler in mechanically ventilated COPD patients: influence of end-inspiratory pause

“…Studies that delivered bronchodilators with MDI directly to the endotracheal tube failed to demonstrate any beneficial effect, even after the administration of high doses of bronchodilators [6]. The use of MDI has several advantages over the nebulizer, such as reduced cost, ease of administration, less personnel time, reliability of dosing and a lower risk of contamination [7][8][9][10].The technique of administration of bronchodilators in mechanically ventilated patients using an MDI and a spacer is an important factor that determines the efficacy of this therapy. Proper timing of the drug delivery, adequate tidal volumes, relatively low inspiratory flows and application of end-inspiratory pause (EIP) (breath-hold) are some of the variables that have been suggested to enhance drug delivery to target sites [4,5].…”

“…Studies that delivered bronchodilators with MDI directly to the endotracheal tube failed to demonstrate any beneficial effect, even after the administration of high doses of bronchodilators [6]. The use of MDI has several advantages over the nebulizer, such as reduced cost, ease of administration, less personnel time, reliability of dosing and a lower risk of contamination [7][8][9][10].…”