Effective application of bronchodilator aerosols from metered-dose inhalers (MDI) via resuscitator-bag and adapter

We developed an adapter enabling the application of therapeutic aerosols fr om metered-dose inhalers (MDI) via a resuscitator bag. This modification pe rmits the bag to act as a spacer which is commonly acknowledged to be a mea ns of improving the efficiency of inhaled aerosolized drugs by reducing imp action in the upper airways and improving the intrapulmonary deposition of particles small enough for intraalveolar penetration. The normal function o f the resuscitator bag remains unchanged enabling use with intubated patien ts receiving artificial ventilation. Methods: A total of 24 patients receiv ing a bronchodilator response test were treated with 200 mu g salbutamol fr om a MDI combined with either a spacer or our bag. Bodyplethysmography and a lung-function-test were performed before and after treatment. Results: Bo th treatments showed a statistically significant reduction of airways resis tance. However, no significant difference between the bag and the spacer co uld be detected. Conclusions: We conclude that the modified resuscitator-ba g is well suited for the inhalative application of drugs by making use of t he established MDI-spacer principle. Use of our modified bag will offer eme rgency preclinical therapy of bronchospasm for patients in need of rapid ef fective relief who were formerly dependent on intravenous treatment. Applic ation in anaesthesia and intensive care also seems possible. (C) 1998 Elsev ier Science Ireland Ltd. All rights reserved.