BRONCHODILATOR RESPONSE WITH USE OF OPTIVENT VERSUS AEROSOL CLOUD ENHANCER METERED-DOSE INHALER SPACERS IN PATIENTS RECEIVING VENTILATORY ASSISTANCE

OBJECTIVE: This study compared the clinical effectiveness of the OptiV ent (HealthScan Products, Inc, Cedar Grove, NJ) and the ACE (DHD, Inc, Canastota, NY) metered dose inhaler (MDI) in-line spacers. DESIGN: Tw o-group, split-plot design with subjects serving as their own controls SETTING: Data were collected in a 1000-bed urban hospital. PATIENTS: A convenience sample of 7 intubated patients receiving mechanical vent ilation. INTERVENTION: Patients received 4 and 8 puffs of albuterol wi th use of both the OptiVent and ACE: devices. RESULTS: Changes in expi ratory airway resistance (Raw), passive peak expiratory flow rate (PEF R), and total work-of-breathing (WOBTOT) were determined using a Bicor e monitor (Bicore Monitoring System; Irvine, Calif). With the ACE, Raw decreased an average of 20.2% and 8.8% in patients receiving 4 and 8 puffs, respectively. With the OptiVent, Raw decreased an average of 34 .6% and 10.8% in patients receiving 4 and 8 puffs, respectively. Impro vements in WOETOT were less than those seen in Raw, and PEER did not t rend with the other 2 variables. The performances of the 2 spacer bran ds were comparable, with no statistical difference (P values > 0.05) f or all 3 variables with use of the nonparametric kolmogorov-Smimov tes t. CONCLUSIONS: These data suggest that use of the OptiVent spacer yie lds comparable clinical results with the ACE spacer in patients receiv ing mechanical ventilation and merits further evaluation.