TY - JOUR T1 - Utilization of Bronchodilators in Ventilated Patients Without Obstructive Airways Disease JF - Respiratory Care SP - 154 LP - 158 VL - 52 IS - 2 AU - Lydia H Chang AU - Shyoko Honiden AU - John A Haithcock AU - Aneesa M Das AU - Kathy A Short AU - David M Nierman AU - Shannon S Carson Y1 - 2007/02/01 UR - http://rc.rcjournal.com/content/52/2/154.abstract N2 - 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. ER -