Administration of inhaled medications during noninvasive ventilation and/or tracheostomy

Abstract

Objectives: To describe the clinical and demographic profile of hospitalized patients undergoing noinvasive ventilation (NIV) and/or tracheostomy (TQT) with prescription of the pressurized inhaler (pMDI) and the difficulties and interventions performed to adapt the inhalation technique. Methods: This is an observational, retrospective and descriptive study of a series of cases, carried out in three clinical units of a university hospital in the years 2017 and 2018. Results: We analyzed data from 25 patients who received NIV and/or TQT for whom guidance has been requested from the Inhalation Techniques Guidance and Training Group (GOTTI). Of these, 15 patients (60%) were using NIV, 5 (20%) were tracheostomized and 5 (20%) were tracheostomized with NIV. The difficulties identified in these patients were insecurity in removing the support, preference for nebulization, adaptation of the pMDI to the cannula and asynchrony between the jet firing and the beginning of inspiration. Conclusions: The use of aero-chamber coupled to the pMDI and tidal volume were the mostly made interventions. Masks and guidelines on the access route to the ventilation system were adapted in most cases This group of patients has particularities and difficulties in the inhalation technique that justify a specific educational intervention by professionals with more in-depth knowledge in the area.