Endobronchial drug administration: does deep endobronchial delivery have advantages in comparison with simple injection through the endotracheal tube?

Abstract

Listen

Translate article

Endobronchial administration of drugs is a valuable alternative to intravenous delivery when venous access cannot be established quickly enough. Some authors propose that deep endobronchial administration through a catheter or similar auxiliary device should give better absorption than simple injection through the endotracheal tube. To test this proposal in the present study two groups of each 6 patients during general anesthesia were administered 3 ml aqueous lidocaine solution at a dose of 2 mg/kg, either deep endobronchially through a catheter or simply through the endotracheal tube. The unusually low volume of administration of 3 ml was chosen because it was thought that the advantages of deep endobronchial administration would then be particularly apparent as 3 ml would lead to a more localized deposit with deep endobronchial administration thus being clearly different from simple injection. No difference in the Pao 2 between the two groups could be statistically established. However, the mean lidocaine plasma concentration in the group with the deep endobronchially administered drug was in tendency lower than in the control group (P < 0.05 at 5 min after delivery). Presumably because of the low volume of administration the mean lidocaine plasma concentrations in both groups always remained under the therapeutic level of at least 1.5 μg/ml. Thus, at least for small volumes and stable circulation the results after deep endobronchial administration through a catheter were somewhat worse than after simple injection through the endotracheal tube.