Intensive care medicine
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Intensive care medicine · Nov 1999
Randomized Controlled Trial Clinical TrialBronchodilator delivery by metered-dose inhaler in mechanically ventilated COPD patients: influence of tidal volume.
The delivery of bronchodilator drugs with metered-dose inhaler (MDI) and a spacer in mechanically ventilated patients has become a widespread practice. However, the various ventilator settings that influence the efficacy of MDI are not well established. The tidal volume (VT) during drug delivery has been suggested as one of the factors that might increase the effectiveness of this therapy. To test this, the effect of two different VT on the bronchodilation induced by beta 2-agonists administered with MDI and a spacer in a group of mechanically ventilated patients with chronic obstructive pulmonary disease (COPD) was examined. ⋯ We conclude that S delivered with an MDI and a spacer device induces significant bronchodilation in mechanically ventilated patients with COPD, the magnitude of which is not affected by at least a 50% increase in VT. These results do not support the VT manipulations when bronchodilators are administered in adequate doses during controlled mechanical ventilation.