Common Canister Protocol for Inhaler Administration in Mechanically Ventilated Patients

Study Overview
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Brief Summary
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Many hospitals employ a common canister inhaler protocol in patients that do not require mechanical ventilator support. Common canister refers to a single inhaler paired with standardized cleaning methods for use on more than one patient. Small reports suggest that this method does not pose an increased infectious risk and is associated with significant cost savings. Common canister protocols offer a solution to the discordance between inhaler sizes and average inpatient use of the drugs. Metered dose inhaler canisters are contain enough drug for several days to weeks of daily use. However, the average length of stay for most inpatients is only several days. Therefore, most inpatients do not use all of the canister contents, an unused resource that is potentially wasted. The common canister approach has not been previously described in mechanically ventilated patients (people requiring intensive care unit admission on breathing machines). This study aims to assess the safety of common canister utilization by assessment and comparison of infection rates in the study and control group.

Official Title
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Common Canister Protocol for Metered Dose Inhaler Administration in Mechanically Ventilated Patients

Conditions
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Ventilator Associated Pneumonia

Intervention / Treatment
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* Other: Common canister


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: mechanically ventilated patients prescribed bronchodilator therapy in a medical intensive care unit Exclusion Criteria: lung transplant neutropenic contact isolation

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Common canister<br>Use of a single MDI (instead of assigning each patient an individual MDI) for multiple mechanically ventilated patients. Inhalers will undergo a stringent cleaning protocol between administrations and storage. | Other: Common canister<br>* Drug administration via a shared canister with a standardized cleaning protocol.<br>|
| No Intervention: Control<br>Each patient will be assigned an individual inhaler as per standard of care practice. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ventilator-associated pneumonia (VAP) | Pneumonia that developed in association with mechanical ventilation | 48 hours after intubation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Inhaler drug cost | Inhaler charges accrued during mechanical ventilation | During period of mechanical ventilation, which varies depending on patient's severity of illness and reason for intubation; on average may range from 3-5 days. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Mechanical ventilation, chronic obstructive pulmonary disease, common canister, MDI, ventilator associated pneumonia, asthma