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Lyu S, Li J, Wu M, He D, Fu T, Ni F, Tan X, Wu G, Pan B, Li L, Wang H, Zeng G, Ni Z, Tan W, Zong Y, Chen L, Liu P, Qin H, He P, Zhang L, An Y, Liang Z. The Use of Aerosolized Medications in Adult Intensive Care Unit Patients: A Prospective, Multicenter, Observational, Cohort Study. J Aerosol Med Pulm Drug Deliv 2021; 34:383-391. [PMID: 34129389 DOI: 10.1089/jamp.2021.0004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background: Only limited data are available on the real-life clinical utilization of aerosolized medications in intensive care unit (ICU) patients. Exploring the utilization of aerosolized medications in the ICU may contribute to develop appropriate education and improve the quality of aerosol therapy. Methods: A 2-week, prospective, multicenter, observational, cohort study was conducted to record how the aerosolized medications were utilized in the Chinese ICUs, including indications, medications used in solo or combination, dosage, and side-effects in adult patients. Results: A total of 1006 patients from 28 ICUs were enrolled, of which 389 (38.7%) received aerosol therapy. The most common indications for aerosol therapy were difficulty in secretion management (23.1%) and chronic obstructive pulmonary disease exacerbation (18.5%). The combination of inhaled corticosteroids and short-acting muscarinic antagonist was the most commonly used medication (19.5%, 76/389). Ninety-two percent (358/389) of the patients did not have any side effects during aerosol therapy. More patients in the group with mechanical ventilation received bronchodilators than spontaneous breathing patients (81.3% vs. 55.5%, p < 0.001), and more patients who breathed spontaneously through a tracheostomy received mucus-regulating agents than other patients (70% vs. 37.9%, p = 0.004). Conclusion: In mainland China, more than one-third of adult ICU patients received aerosol therapy. Medications utilized during aerosol therapy were variable in patients with different respiratory support. To promote appropriate use of aerosolized medications, high-quality randomized, controlled trials and clinical guidance on aerosolized medication indications and dosing are needed to improve clinical outcomes.
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Affiliation(s)
- Shan Lyu
- Department of Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Jie Li
- Division of Respiratory Care, Department of Cardiopulmonary Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Mengmeng Wu
- Department of Critical Care Medicine, Binzhou People's Hospital, Binzhou, China
| | - Dehua He
- Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tinggan Fu
- Department of Surgical Intensive Care Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Fang Ni
- Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Wuhan, China
| | - Xu Tan
- Department of Respiratory and Critical Care Medicine, Union Hospital Affiliated with Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Guanghan Wu
- Department of Critical Care Medicine, People's Hospital of Jianghua Yao Autonomous County, Yongzhou, China
| | - Binhai Pan
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Nanjing, China
| | - Liucun Li
- Department of Respiratory and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Haiyan Wang
- Department of Emergency Critical Care Medicine, West China Hospital Sichuan University-Ziyang Hospital, Ziyang, China
| | - Guilan Zeng
- Department of Critical Care Medicine, Zhangzhou Hospital Traditional Chinese Medicine, Zhangzhou, China
| | - Zhong Ni
- Department of Respiratory and Critical Care Medicine, West China Medical Center, Sichuan University, Chengdu, China
| | - Wei Tan
- Department of Respiratory and Critical Care Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Yajuan Zong
- Department of Critical Care Medicine, Yixing No.2 People's Hospital, Yixing, China
| | - Lihua Chen
- Department of Critical Care Medicine, Gansu Second Provincial People's Hospital, Lanzhou, China
| | - Ping Liu
- Department of Critical Care Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Hao Qin
- Department of Respiratory and Critical Care Medicine, Shanghai Changhai Hospital, Shanghai, China
| | - Ping He
- Department of Cardiac Surgery, Southwest Hospital, The First Hospital Affiliated to Army Medical University, Chongqing, China
| | - Liu Zhang
- Department of Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Youzhong An
- Department of Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Zongan Liang
- Department of Respiratory and Critical Care Medicine, West China Medical Center, Sichuan University, Chengdu, China
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