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• W2075078237 abstract "Although I hate to “rain on the parade” of Khorfan and colleagues,1Khorfan FM Smith P Watt S Barber KR Effects of nebulized bronchodilator therapy on heart rate and arrhythmias in critically ill adult patients.Chest. 2011; 140: 1466-1472Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar it is possible, if not likely, that methodologic nuances of aerosol delivery undermine the validity of their conclusions in their article in CHEST (December 2011), which states that “nebulized albuterol does not cause significant tachycardia or tachyarrhythmias.”1Khorfan FM Smith P Watt S Barber KR Effects of nebulized bronchodilator therapy on heart rate and arrhythmias in critically ill adult patients.Chest. 2011; 140: 1466-1472Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar In delivery of therapeutic aerosols, the devil is in the details, and the “Materials and Methods” section in the article does not provide any information regarding the aerosol delivery techniques used for study patients.1Khorfan FM Smith P Watt S Barber KR Effects of nebulized bronchodilator therapy on heart rate and arrhythmias in critically ill adult patients.Chest. 2011; 140: 1466-1472Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar This is especially true in patients who are mechanically ventilated, who composed >50% of the sample, in which we proved that veritably none of 100 puffs of albuterol was delivered to patients' airways.2Manthous CA Hall JB Schmidt GA Wood LD Metered-dose inhaler versus nebulized albuterol in mechanically ventilated patients.Am Rev Respir Dis. 1993; 148: 1567-1570Crossref PubMed Google Scholar Multiple variables, including circuit design, humidification, flow rates, and tidal volumes, impact aerosol delivery to critically ill patients.3Manthous CA Hall JB Administration of therapeutic aerosols to mechanically ventilated patients.Chest. 1994; 106: 560-571Abstract Full Text Full Text PDF PubMed Scopus (29) Google Scholar Poor techniques can lead to the illusion of treatment (ie, doses administered but not delivered to the airways because they rain out in the circuit). Accordingly, this study should be interpreted cautiously, because no evidence (eg, of reduced airway resistance) is provided to support that any of the administered doses were delivered. Aerosols and Details: ResponseCHESTVol. 141Issue 5PreviewWe thank Dr Manthous for his interest in our recent article in CHEST1 and appreciate his comments. Our article concluded that the use of short-acting β-agonist albuterol and a short-acting anticholinergic ipratropium bromide in the recommended commonly used doses and frequency appear not to have a clinically significant detrimental effect on heart rate and rhythm.1 Full-Text PDF" @default.
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• W2075078237 date "2012-05-01" @default.
• W2075078237 modified "2023-09-27" @default.
• W2075078237 title "Aerosols and Details" @default.
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• W2075078237 doi "https://doi.org/10.1378/chest.11-3118" @default.
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