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Inhaled bronchodilators are routinely administered to mechanically ventilated patients to relieve dyspnea and reverse bronchoconstriction. A lower percentage of the nominal dose reaches the lower respiratory tract in a mechanically ventilated patient than in a nonintubated subject, but attention to device selection, administration technique, dosing, and patient-ventilator interface can increase lower-respiratory-tract deposition in a mechanically ventilated patient. Assessing the airway response to bronchodilator by measuring airway resistance and intrinsic positive end-expiratory pressure helps guide dosing and timing of drug delivery. Selecting the optimal aerosol-generating device for a mechanically ventilated patient requires consideration of the ease, reliability, efficacy, safety, and cost of administration. With careful attention to administration technique, bronchodilator via metered-dose inhaler or nebulizer can be safe and effective with mechanically ventilated patients.
- mechanical ventilation
- β agonist
- chronic obstructive pulmonary disease
- inhalation therapy
- noninvasive ventilation
- Correspondence: Alexander G Duarte MD, Division of Pulmonary and Critical Care Medicine, University of Texas Medical Branch, Galveston TX 77555-0561. E-mail: .
- Copyright © 2004 by Daedalus Enterprises Inc.