PT  - JOURNAL ARTICLE
AU  - Duarte, Alexander G
TI  - Inhaled Bronchodilator Administration During Mechanical Ventilation
DP  - 2004 Jun 01
TA  - Respiratory Care
PG  - 623--634
VI  - 49
IP  - 6
4099  - http://rc.rcjournal.com/content/49/6/623.short
4100  - http://rc.rcjournal.com/content/49/6/623.full
AB  - 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.