The Journal of asthma : official journal of the Association for the Care of Asthma
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Randomized Controlled Trial Clinical Trial
Assessing the use of metered dose inhalers by adults with asthma.
The development and analysis of an instrument to evaluate the use of metered dose inhalers by patients in the University of Alabama at Birmingham (UAB) Asthma Program is presented. A total of 238 adult asthma patients demonstrated use of the metered dose inhaler for this analysis. Patient skill in using the inhaler was recorded using the instrument, Inhaler-Use Checklist, developed at UAB. The study found that most patients use metered dose inhalers incorrectly, despite training received from their physicians on proper use of inhalers.
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Ten patients with status asthmaticus and respiratory or combined respiratory and metabolic acidosis were treated with a mixture of helium-oxygen (He-O2) in addition to the usual bronchodilator therapy and corticosteroids. A significant reversal of the acidosis was noted within the first 20 minutes, and no patient required subsequent intubation. ⋯ There were no untoward reactions and most of the patients sensed an immediate reduction in their dyspnea with the onset of He-O2 therapy. We conclude that He-O2 may be a useful adjunct to the usual medications employed in the treatment of status asthmaticus and may allow some patients to avoid intubation and mechanical ventilation.