Which of the following methods is acceptable for delivering a drug via a pMDI to an intubated neonate receiving mechanical ventilation?

Question

Quizplus · Accepted Answer

The administration of medication by pMDI to the mechanically ventilated neonate may not be well tolerated. Leaving a chamber device in-line is not practical because of the increased compressible volume incorporated into the ventilator circuit. Depending on the FiO₂ and the propellant gas volume, an in-line pMDI actuation theoretically may result in the delivery of a hypoxic gas mixture to an infant receiving a tidal volume less than 100 mL. It is possible to deliver a pMDI aerosol medication to the intubated neonate, especially for medications available only in pMDI preparations. However, it may be preferable to hand-ventilate the pMDI delivery of medication to the patient. If a chamber adapter is used, the infant must be removed from the circuit, the chamber placed in-line, and the infant reattached to the circuit before the pMDI is administered. The large dead space volume caused by placing a spacer or chamber at the end of the ETT must also be considered when administering pMDI medications to an infant.

Which of the Following Methods Is Acceptable for Delivering a Drug