INFLUENCE OF MECHANICAL VENTILATION MODES ON THE EFFICACY OF NEBULIZED BRONCHODILATOR IN THE TREATMENT OF PATIENTS WITH OBSTRUCTIVE PULMONARY DISEASE
Bronchodilator, Mechanical Ventilation, Asthma, COPD.
Inhaled bronchodilator drug administration during invasive mechanical ventilation (MV) is a very common practice in Intensive Care Unit (ICU). However, the studies reveal variability in drug delivery efficiency. This study aims to evaluate the influence of mechanical ventilation modes on the efficacy of nebulized bronchodilator in the treatment of patients with obstructive pulmonary disease. This is a blind clinical trial. The intervention protocol consists in performing nebulization (Salbutamol Sulfate, 5mg and
Ipratropium bromide, 0.5 mg) associated with invasive MV. The ventilation mode was which the patient was found, but adjustments were done with the objective of optimizing aerosol deposition. Patients under sedation and in controlled MV performed twice the intervention protocol with a randomized order: with PEEP adjusted in 85% of autoPEEP and with the PEEP elevated to 15 cmH2O.Before and immediately after each intervention protocol, the patients were evaluated through Electrical Impedance Tomography (EIT). The outcomes variables analyzed was: total lung ventilation by total impedance variation (ΔZTOT), total lung aeration by End-Expiratory Lung Volume (EELVTOT) and the distribution of regional lung ventilation and aeration by impedance variation on dependent and non-dependent pulmonar regions. It is planned to publish two scientific articles with the data collected.