Ambulatory antibiotic infusion devices: extending the spectrum of outpatient therapies.

Study Objective: To examine the safety and efficacy, as well as the economic impact, of outpatient intravenous antibiotic administration using an ambulatory infusion pump.

Design: Retrospective analysis of patients treated through a single home care pharmacy.

Setting: General community and skilled nursing facilities of the greater Monterey (California) area.

Lung imaging with radioaerosols for the assessment of airway disease.

Aerosol inhalation lung scans offer distinct advantages in the evaluation of airways and the qualitative distribution of ventilation. The sensitivity in detecting mild obstructive disease is similar to that of xenon washout and both probably surpass standard pulmonary function tests that measure total rather than regional ventilation. Although imaging studies using krypton gas are ideal for assessment of rapidly ventilated space, krypton's short half-life precludes its usefulness for demonstrating air trapping.

Accelerated clearance of small solutes from the lungs in interstitial lung disease.

Solutions of 99mTc-diethylenetriaminepenta-acetate (99mTc-DTPA) and 99mTcO-4 were aerosolized and inhaled by subjects seated against a scintillation camera. Initial clearance rates of these radionuclides were determined over 6 posterior lung regions. Clearance of 99mTcO-4 (molecular weight, 163 dalton exceeded that of 99mTc-DTPA (molecular weight, 492 daltons) by an average factor of 3.

Sites of airway dilatation in asthma following inhaled versus subcutaneous terbutaline. Comparison of physiologic tests with radionuclide lung images.

In 12 asthmatic subjects with mild to severe airways obstruction, we compared the relative magnitude and sites of airway dilatation of a beta-adrenergic stimulant administered by different routes. Specific airway conductance (SGaw), peak expiratory flow, the sum of the absolute volume of isoflow and residual volume as a percentage of total lung capacity (capacity of isoflow) and the ratio of maximal expiratory flow at 50 per cent of vital capacity breathing 80 per cent helium-20 per cent oxygen to that breathing air (ratio Vmax50) were determined before and after the administration of aerosolized terbutaline (0.5 mg), subcutaneous terbutaline (0.

Imaging sites of airway obstruction and measuring functional responses to bronchodilator treatment in asthma.

The sites of airway obstruction and dilatation after terbutaline administration were studied by inhalation imaging and pulmonary function tests in 12 stable asthmatic patients. Inhaled terbutaline as a therapeutic aerosol decreased airway resistance (Raw) and improved radioaerosol (Ae) images in nine, delta V max50 in three, and xenon (Xe) images in five of 12 subjects, suggesting that its predominant site of action was on major airways. Subcutaneously injected terbutaline improved Raw, delta V max50, and Ae images in 11 and Xe images in eight subjects indicating that it released bronchospasm in the major and minor airways.