PT  - JOURNAL ARTICLE
AU  - Russell Graham
AU  - Roberta Melton
AU  - Adam Mullaly
AU  - Stanley Rhone
AU  - James Fink
TI  - Does technology matter? One intensive care unit's experience
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P2019
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P2019.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P2019.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - Background: Pneumatic nebulizers (PN) can add significant flow to the circuit and can harbor harmful pathogens.1 Use of a PN with mechanical ventilation (MV) often results in incomplete nebulization with retrograde contamination from the patient. Vibrating mesh nebulizers (VMN) have a physical barrier between the aerosol pathway and the medication reservoir, reducing risk of contamination. We hypothesized VMN would provide more effective therapy and potentially reduce the risk of VAP. Method: The Neuroscience ICU Respiratory Therapists initiated a QI project, trialing a VMN (Aerogen, Galway, Ireland), locating one controller in each room to avoid cross-contamination issues as part of a VAP reduction strategy. All medicated aerosol was perormed by VMN. Cumulative data was compiled for the 12 months prior. The new method (VMN) was used for 9 months, resuming the old method for an additional 60 day period (to act as an additional control) Results: View this table:Table 1Use of VMN resulted in a 15% drop in vent days, with a 19% increase during the 60 day return. LOS decreased by 28.7% during the study period. There was no statistically significant change in VAP rate, possibly due to the change in weighted value from the decreased vent days. Conclusions: VMN was preferred by the therapists. In this instance, the advent of technology was felt to make a significant impact on patient care. Further study of the impact of choice of aerosol delivery device on patient outcome is indicated.1 Respir Care 2005;50(6):725-741.