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Common Canister Protocol for Inhaler Administration in Mechanically Ventilated Patients

This study has been completed.
Information provided by (Responsible Party):
Peggy Watts, Washington University School of Medicine Identifier:
First received: July 31, 2013
Last updated: October 6, 2016
Last verified: October 2016

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.

Condition Intervention Phase
Ventilator Associated Pneumonia Other: Common canister Phase 4

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Common Canister Protocol for Metered Dose Inhaler Administration in Mechanically Ventilated Patients

Resource links provided by NLM:

Further study details as provided by Peggy Watts, Washington University School of Medicine:

Primary Outcome Measures:
  • Ventilator-associated pneumonia (VAP) [ Time Frame: 48 hours after intubation ]
    Pneumonia that developed in association with mechanical ventilation

Secondary Outcome Measures:
  • Inhaler drug cost [ Time Frame: 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. ]
    Inhaler charges accrued during mechanical ventilation

Enrollment: 354
Study Start Date: June 2013
Study Completion Date: March 2016
Primary Completion Date: February 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Common canister
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
Drug administration via a shared canister with a standardized cleaning protocol.
No Intervention: Control
Each patient will be assigned an individual inhaler as per standard of care practice.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • mechanically ventilated patients prescribed bronchodilator therapy in a medical intensive care unit

Exclusion Criteria:

  • lung transplant
  • neutropenic
  • contact isolation
  Contacts and Locations
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Please refer to this study by its identifier: NCT01935388

United States, Missouri
Barnes-Jewish Hospital
Saint Louis, Missouri, United States, 63110
Sponsors and Collaborators
Barnes-Jewish Hospital
Principal Investigator: Marin Kollef, MD Washington University School of Medicine
  More Information

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Peggy Watts, MD, Washington University School of Medicine Identifier: NCT01935388     History of Changes
Other Study ID Numbers: BJH CCP
Study First Received: July 31, 2013
Last Updated: October 6, 2016

Keywords provided by Peggy Watts, Washington University School of Medicine:
Mechanical ventilation
chronic obstructive pulmonary disease
common canister
ventilator associated pneumonia

Additional relevant MeSH terms:
Pneumonia, Ventilator-Associated
Lung Diseases
Respiratory Tract Diseases
Respiratory Tract Infections
Cross Infection
Ventilator-Induced Lung Injury
Lung Injury processed this record on August 23, 2017