@article {Chang154, author = {Lydia H Chang and Shyoko Honiden and John A Haithcock and Aneesa M Das and Kathy A Short and David M Nierman and Shannon S Carson}, title = {Utilization of Bronchodilators in Ventilated Patients Without Obstructive Airways Disease}, volume = {52}, number = {2}, pages = {154--158}, year = {2007}, publisher = {Respiratory Care}, abstract = {OBJECTIVE: To examine physician practice in, and the costs of, prescribing inhaled bronchodilators to mechanically ventilated patients who do not have obstructive lung disease. METHODS: This was a prospective cohort study at 2 medical intensive care units at 2 tertiary-care academic medical centers, over a 6-month period. Included were the patients who required >= 24 hours of mechanical ventilation but did not have obstructive lung disease. Excluded were patients who had obstructive lung disease and/or who had undergone \> 24 hours of mechanical ventilation outside the study intensive care units. RESULTS: Of the 206 patients included, 74 (36\%) were prescribed inhaled bronchodilators without clear indication. Sixty-five of those 74 patients received both albuterol and ipratropium bromide, usually within the first 3 days of intubation (58 patients). Patients prescribed bronchodilators were more hypoxemic; their mean PaO2/FIO2 ratio was lower (188 mm Hg versus 238 mm Hg, p = 0.004), and they were more likely to have pneumonia (53\% vs 33\%, p = 0.007). The mean extra cost for bronchodilators was $449.35 per patient. Between the group that did receive bronchodilators and the group that did not, there was no significant difference in the incidence of ventilator-associated pneumonia, tracheostomy, or mortality. The incidence of tachyarrhythmias was similar (15\% vs 22\%, p = 0.25). CONCLUSIONS: A substantial proportion of mechanically ventilated patients without obstructive lung disease received inhaled bronchodilators.}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/52/2/154}, eprint = {https://rc.rcjournal.com/content/52/2/154.full.pdf}, journal = {Respiratory Care} }