Tsai Mei, Suggett Jason, Co Anthony, Ginder Tammy
Torrance Memorial Medical Center, Torrance, CA, USA.
Trudell Medical International, London, UK.
Hosp Pharm. 2024 Dec;59(6):631-637. doi: 10.1177/00185787241254994. Epub 2024 May 23.
The COVID-19 pandemic led to unprecedented shortages of albuterol sulfate metered dose inhalers (MDIs) utilized in the supportive management of respiratory symptoms in patients with SARS-CoV-2 infections. The risk of generating infective aerosols in nebulized treatments increased the demand for metered dose delivery, leading to a worldwide shortage of albuterol sulfate MDIs. Previous common canister protocols involve the recycling and cleaning of canisters for multiple patient use, however have not undergone quality control studies on viral cross-contamination. Torrance Memorial Medical Center utilized an off-label method of common canister administration through spacer devices, forgoing the need for sterilization while conserving albuterol sulfate during a public health emergency. A retrospective review of this emergency department protocol was conducted on 329 patients receiving this novel albuterol sulfate common canister method over a 10-month period between 3/23/2020 to 1/23/2021. Results showed 265 patients (80.5%) had improved aeration determined by breath sounds evaluation by the respiratory therapist and patient interview. Purchasing records reviewed since 3/1/2020 show purchases were sufficient to sustain albuterol sulfate MDI supply so that no treatments were delayed omitted during the 10-month evaluation period. This novel approach to common canister delivery offers a promising measure to conserve a vital inhaled medication during a public health emergency and could serve as a basis for future development of conservation and quality control studies.
2019冠状病毒病大流行导致硫酸沙丁胺醇定量吸入器（MDIs）出现前所未有的短缺，这种吸入器用于支持治疗感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的患者的呼吸道症状。雾化治疗中产生感染性气溶胶的风险增加了对定量给药的需求，导致全球硫酸沙丁胺醇MDIs短缺。以前常见的药罐方案包括药罐的回收利用和清洁，以供多名患者使用，但尚未进行关于病毒交叉污染的质量控制研究。托伦斯纪念医疗中心在公共卫生紧急情况期间，通过间隔装置采用了一种标签外的常见药罐给药方法，无需进行消毒，同时节省了硫酸沙丁胺醇。对2020年3月23日至2021年1月23日这10个月期间接受这种新型硫酸沙丁胺醇常见药罐方法治疗的329名患者的急诊科方案进行了回顾性研究。结果显示，265名患者（80.5%）经呼吸治疗师通过呼吸音评估和患者访谈确定通气得到改善。自2020年3月1日以来审查的采购记录显示，采购量足以维持硫酸沙丁胺醇MDIs的供应，因此在10个月的评估期内没有治疗被推迟或遗漏。这种新型的常见药罐给药方法为在公共卫生紧急情况期间保存一种重要的吸入药物提供了一种有前景的措施，并且可以作为未来保存和质量控制研究发展的基础。
