The document discusses the potential use of metered-dose inhalers (MDIs) to deliver bronchodilators to mechanically ventilated patients. While MDIs deposit medication in the endotracheal tube rather than the lungs, evidence shows they can still achieve a significant bronchodilator effect with smaller doses. Several in vitro and in vivo studies have found that MDIs can deliver acceptable amounts of medication to patients and have similar effectiveness to nebulizers at reduced cost and risk of contamination. However, factors like ventilator settings and humidification use need to be considered to maximize drug delivery with MDIs.