Inhalation therapy with metered dose inhaler during invasive mechanical ventilation
DOI:
https://doi.org/10.24220/2318-0897v33a2025e10209Keywords:
Administration, inhalation, Bronchodilator agents, Intensive care units, Metered dose inhalers, Respiration, artificialAbstract
Objective
To describe the clinical profile of mechanically ventilated patients requiring fixed-dose bronchodilator inhalation, to detail the employed inhalation technique, and to assess the effects of medication administration on respiratory mechanics.
Methods
This was a descriptive, observational case series conducted in an intensive care unit over a two-month period at a hospital in southern Brazil. The study included adult patients of both genders who were prescribed bronchodilator inhalation via a pressurized metered-dose inhaler while undergoing mechanical ventilation. The following information was collected: clinical data contained in the electronic medical record, inhalation technique used, heart rate, respiratory mechanics parameters (static and dynamic compliance, inspiratory and expiratory tidal air
volume) pre-administration, 1 minute and 5 minutes after inhalation.
Results
A total of 14 patients were included in the study. The majority had associated pneumonia and had no history of prior respiratory disease. Salbutamol was the prescribed drug, and a standard inhalation technique using an adaptable chamber to the circuit was employed for all individuals. There was no statistically significant difference observed in the measured respiratory mechanics parameters before and after medication administration. Heart rate showed statistical significance at two time points: when compared pre-administration versus 5 minutes, and when compared 1 minute versus 5 minutes (p<0.05).
Conclusion
The use of an adaptable chamber to the circuit and proper technique are essential for optimizing inhaled therapy during mechanical ventilation. The bronchodilator effect could not be demonstrated. Further studies are needed for a better understanding of this topic.
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References
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