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Respiratory care : the official journal of the American Association for Respiratory Therapy PDF

180 Pages·1991·12 MB·English
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September 1991 Volume 36, Number 9 ISSN00989142-RECACP A MONTHLY SCIENCE JOURNAL 36TH YEAR—ESTABLISHED 1956 Aerosol Consensus Statement—1991 SPECIAL ISSUE Advantages of the Aerosol Route CONSENSUS CONFERENCE ON AEROSOL DELIVERY Clinical Aspects of Aerosol Physics Aerosol Generators & Delivery Systems Patient & Aerosol Generator Interface Dosing Strategies for Aerosol Parenchymal Aerosol Therapy Aerosol Therapy in Children Escape of Aerosolized Medication into the Environment Control of TB during Aerosol Therapy Toxicology of Ribavirin & Pentamidine MDI Propellants; Environmental Impact Unlimited The new 7200*aeventilator. A simplified keyboard. Easier-to- use. Easier-to-learn. It's as simple Simplicity. as that, ifyou'd like to learn more, that's easy too. Call 1-800-255-6773. -1 —IPURITAN iBEIMIMETTs Circle 108on readerservicecard The new 7200'ae ventilator. A Simply powerful new microprocessor for graphics, pressure control ventila- Unlimited. tion, and more. As always a quick, easy upgrade away. More options today more tomorrow. Call . . . 1-800-255-6773. It's that simple. PURITAN BENNETT® Circle 128 on reader service card Our New In Deveidping pft System, A We Achieved SmallGoal. \bu'll noticeasizabledifterence in ournew MLCompact" Asforreports, withMLCompact youcandesign them to PFTsystemrightaway. look thewayyou (and MedicalRecords) wantthemto. Put — It offersafull rangeoftests, includingflow-volumeloops, graphsand text anywhere top, bottom, left, right. Createas slowVC, MVV, FRC viahelium dilution, andsingle-breath manyformatsasyou like. DLCO testing. lbget thebigpicture,give usacall; we'llsenda little Yet it'sallcontained in a small, POcompatihlepackage. inforrnationyourway. So it fits inyourofficeor labeasily USAandCanadacalltollfree: It hasaremovable \alveblock that makescleaningand 2D1o2m1esTteirrcySAavleensu8e0:0S/e4a2t6tl-e0.3W47ACa9n81a2d1a-2S7a9l1es800/633-2888 - sterilizationsignificantlyeasier(flipa leverand thewhole Telex3794094 QUINTONSEA; FAX 206/223-8465 blockdrops into yourhand). And itusesMicrosoft'Windows (just like ourtuU-size Quinton* MasterLab"),so ifyoucan point and click with a mou.se, you've instrumentCO cleared amajorhurdle inmasteringthesystem. MMKuttocHriLtithi\ISnarergcigaucircerdcdttrraadJccnnuujirriiiatiMMEknmckhdIjAtcgQcirpUmhH&QvKG Circle 105on readerservicecard RE/PIRATORy C&RE A Monthly ScienceJournal. Established 1956. Official Journal ofthe American Association tor Respiratory Care. EDITORIALOFFICE CONTENTS September 1991 11030AbiesUne Volume 36, Number9 DallasTX75229 (214)243-2272 EDITOR PatBrougherRRT SPECIAL ISSUE ADJUNCTEDITOR PhilipKitlredgeRRT MANAGING EDITOR CONSENSUS CONFERENCE ON Ra> MasferrerRRT AEROSOL DELIVERY EDITORIALCOORDINATOR DonnaStephens EDITORIALBOARD NeilMaclntyrcMD.Chairman The Proceedings ofaConference ThomasABarnesEdDRRT RichardDBransonRRT heldJanuary 10-12, 1991, RobertLChatburnRRT in Cancun. Mexico CharlesGDurhinJrMD ThomasDEastPhD DeanHessMEdRRT RobertMKacmarekPhDRRT EDITORIALS DavidJPiersonMD 914 Aerosol Therapy: The Hard Questions JamesKStollerMD — CONSULTINGEDITORS bySam P Giordano Dallas, Texas FrankEBiondoBSRRT HJoohwnarGdBJurBfiorrednMbaDumMD CONSENSUS STATEMENTS BobDemersBSRRT — DouglasBEdenBSRRT 916 Aerosol Consensus Statement 1991 DonaldREllonMD by Consensus Conference Participants RobertRRuckJrMSRRT RonaldBGeorgeMD JChaamrelsesMGHIurrvstmMPhDD CONFERENCE PROCEEDINGS MSJastremskiMD HughSMalhewsonMD 922 Clinical Advantages ofthe Aerosol Route ofDrug Administration MichaelMcPeckBSRRT — RichardRRichardBSRRT byNils Svedniyr Gothenburg. Sweden JohnShigeokaMD RBnanSmuhMD JackWangerRCPTRRT JeffresJWardMEdRRT 931 Clinical Aspects ofAerosol Physics JOURNALASSOCUTES — StephenMAyresMD bvMvrna Dolovich Hamilton, Ontario, Canada ReubenMChemiackMD JosephMCivettaMD JohnBDownsMD DonaldFEganMD 939 Aerosol Generators and Delivery Systems GarethBGishMSRRT — GeorgeGregoryMD byStephen PNewman Nottingham. UnitedKingdom AkeGrenvikMD HFredenckHelmholzJrMD JohnEHodgkinMD WTElihiloalmniaaJsmNLeFlPMseiollnllveRrMNMDRDRT 952 TbyheRoIbnetrertfaMceKbaectmwaereenkPaatnidenDteaanndHAeesrsos—olBoGsetnoen.raMtaosrsachusetts and AlanKPierceMD HenningPontoppidanMD York. Pennsylvania JohnWSevennghausMD BarryAShapiroMD PRODUCTIONSTAFF 977 Dosing Strategies for BronchodilatorAerosol Delivery DonnaKnauf — JudeRevoii by DonaldP Tashkin LosAngeles, California JeannieMarchant RESPIRATORY CARE (ISSN 00989142) is a monthly publication of Daedalus Enterprises. Inc. for the American Association for Respiratory Care Copyright ® 1991 b> Daedalus EnterprisesInc. 11030AbiesLane. DallasTX 75229. Allrightsreserved. Reproduction in wholeorin part withouttheexpress,written permission ofDaedalus Enterprises. Inc. is prohibited. The opinions expressed in any article or editorial are those of the author and do not necessarily reflect the views of Daedalus Enterprises, Inc. the Editorial Board, or the American Association for Respiratory Care, Neither can Daedalus Enterprises. Inc. the Editorial Board, or the American Association for RespiratoryCareberesponsiblefortheconsequencesoftheclinicalapplicationsofanymethodsordevicesdescribedherein. RespiratoryC^RFisindexedinHospitalLiteratureIndexandin CumulativeIndextoNursingandAlliedHealthIJterature. SubscriptionRates;S5.(K)percopy:$50.00peryear112issues)intheUS;S70.(K)inallothercountries(add$84,00forairmail). Second CIas.s Postage paid at Dallas. TX. POSTMASTER: Send address changes to RESPIRATORY CARE, Daedalus Enterprises. Inc. 11030 Abies t^ane. Dallas TX 75229. RESPIRATORY CARE • SEPTEMBER "91 Vol 36 No 9 891 sleep Testing Imagine the people you can reach, the needs you can fulfidl. Iiisoniniu f-hlldii-iip Hypertension 'riticalCare CNS.lnc. 1250ParkRoad,Chanhassen,MN 35317-9260. (800)843-2978. InMN (612)474-7600 InEurope:ErichJaeger GmbHGeimany,0931/41902-0 Circle 117on readerservicecard 1 MANUSCRIPTSUBMISSION CONTENTS, September 1991 InstructionsforAuthorsandTypistsispnntednear CiiiiiiiiiutI \Oliime 36, Number 9 theendofeveryissueofRespiratoryCarf. PHOTOCOPYING&Ql'OTATION PHOTOCOPYING, Any matenal in thisjournal that IS copynghted hy Daedalus Enterpnscs, Inc. may bephottKopiedfornoncommercial purposes 989 DDsing Strategies for Aerosol Delivery to tiie Lung Parenchnia, with ofscientificoreducationaladvancement, QUOTATION-Anyonemay,withoutpermi.ssion. Specific Recommendations for Pentami—dine quoteupto 500wordsofmaterial in thisjournal /)V Hcinrich Mutthys andRosa Hercei> Freihuri;, Germany that IScopyrightedby Daedalus Enterprises. Inc. provided thequotation isfor noncommercial use. and provided RtspiRAroRV Care is credited. Longerquotationrequireswnttenapprovalbythe 994 Aerosol Therapy—in Children authorandpublisher, /;yRMichaelSly Washington, District of Columhin SUBSCRIPTIONS/CHANGEOFADDRESS Respirators Care 1008 Aerosol E.vhaust: Escape ofAerosolized Medication into the Patient 11030AbiesUne DallasTX75229 and Caregiver's Environment — (214)243-2272 byRobertJ Fallat anil Kailirxn Kandal San Francisco. California SUBSCRIPTIONS, Individual subscnption rates are $50,00 per year (12 issues) in the US, and PuertoRico.$70.00peryearinallothercountries; 1017 Control ofTuberculosis during Aerosol Therap—y Administration $95.00 for 2 years in the U.S. and Puerto Rico. byRichardEChaisson andSharon McAvinne Baltimore. Marx- $135.00 in all other countries; and $14000 for 3 years in the U.S. and Puerto Rico. $200.00 in land all other countries (add $84.(K) per year for air mail). Annual organizational subscriptions are offered to members of associations according to 1026 Toxicology ofAntimicrobial Aerosols: A Review ofAerosolized Ri- their membershipenrollmentasfollows: 101-500 bavirin and Pentamidine members—$5.00. 501-1.500 members—$4.50. — 1.501-2.500 members—$4.25, 2.501-5,000 byHetty Waskin Durham, North Carolina members—$4.00,5.001-10.000members—$3.00. andover 10,000members—$2.00.Singlescopies, when available, cost $5.00; add $7.00 air mail 1037 Propellant Gases in Metered Dose Inhalers: Their Impact on the postagetoforeigncountnesoverseas. Global Environment — CHANGE OF ADDRESS Six weeks notice is byJohn RBalmes San Francisco, California required toeffectachange ofaddress. Note your subscnptionnumber(fromthemailinglabel),your name, and both old and new addresses, included ABSTRACTS zip codes. Please note your subscnption number on the envelope. Copies will not be replaced 899 Summaries ofPertinent Articles in OtherJournals withoutchargeunlessarequestisreceivedwithin 60 days of the mailing in the U.S. or within 90 daysinothercountries. CALENDAR OF EVENTS MARKETINGDIRECTOR 1046 Meeting Dates, Locations, Themes DaleGriffiths ADVERTISINGASSISTANT BethBinkley NOTICES ADVERTISING. Display advertising for the Journal should be arranged with the advertising 1051 Examination Dates, Notices, Prizes representatives. Respiratory Care does not publishaclassifiedadvertisingcolumn. INFORMATION FOR AUTHORS ADVERTISING: RATESANDMEDIAKITS 1053 Instructions for Authors andTypists AnesAdvertisingRepresentatives SaulHornik SandyGetterman INDEXES 12CourtSt FreeholdNJ07728 1056 Authors in This Issue (201)462-7422or972-191 1056 Advertisers in This Issue 1050 Advertiser Help Lines RESPIRATORY CARE • SEPTEMBER 91 Vol 36 No 9 893 Designed to I>elivet^ Directly to the \ With theAeroVentdevice, youmedicatewithoutcompromisingtheintegrityoftheventilator circuitand withouttakingvaluabletime forSmallVolume Nebulizer(SVN) hook-upsor circuitdisconnections TheAeroVentdeviceincorporatesmanydesigninnovations — . including features ofthe AerochamberJ aerosol delivery system. The AeroVent device is designed for convenient single patient use. Aerosol Medications ^ntilated Patient. TheAeroVentholding chambercanbelatched whencollapsed in the circuit, ready forthenext timeyouneed tomedicate thepatient.Simplyunlatch, 4 expand theAeroVentdevice and actuatetheaerosol medicationfromtheme- tereddoseinhaler(MDl). The AeroVent device includes a built- in snap closure to keep the AeroVent The AeroVent device has collapsed while in place and not in been tested and proven use, allowing unrestricted gas flow to deliver 4.5 times greater through the breathing circuit. deposition than a standard SVN to the mechanically ventilated patient. ' • FullerHD.Doiovich MB,PosmiUickG,Wong PackW.andNewhouse MT.PressurizedAerosol versusJetAerosolDeliv- erytoMechanically VentilatedPatients: Comparisonofdoseto thelungs AmRe\ RespirDis;141:440-444 ^^B ^ 3rdpuff-10min 4lhpuff-ISmin GraphicRepresentation ofActualLungDeposition Data. monaghan P.O. Box 2805, Plattsburgh, NY 12901 800-833-9653 518-561-7330 / Monaghan Medical Corporation Fax: 518-561-5660 Circle 142on readerservicecard - Now Available! SURVANIA beractant intratracheal suspension 8mlSingleDoseVial NOC0074-1040-08 beractant intratracheal suspension SterileSuspension forIntratracheal "AdministrationOnly NotForInjection 00NOTSHAKE iTOREATrioBX rFROMLIGHT acheal! From Ross Laboratories- Helping Premature Babies Survive Pleasesee adjacentcolumnforBriefSummaryofprescribing information. A8688/1970 COLUMBUS. OHIO.aaaie S'1991 RossLaboratories AbbguLaboraumes us« LITHOINUSA -ipecard ffii: 9»

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