Respiratory Therapy

- Delivers medication directly to where it is needed.
- Direct action of the drug on the target organ.
- Immediate effect after inhalation.
- Same effects as oral medication, but with lower dosage.
- Minimisation of possible systemic adverse effect risks.
- Patients can inhale medication with no coordination¹ needed.
- Possible to mix different medications from prescription².
- Some devices can be used for treating upper and lower airway diseases with one device.

Reference: (1) Laube BL et al (2011). What a pulmonologist should know about the new inhalation therapies. Eur Respir J. 37(6):1308-31. (2) Gardenshire D et al (2013). A guide to aerosol therapy for respiratory therapists - 3rd ed. American Association for Respiratory Care , p. 10.

Different Types Of Nebulizers for various uses

1. Compressor Nebulizer

Benefits

- Easy to use, also suitable for children
- Almost all types of medication is supported
- Very reliable
- Cost-effective

Disadvantages

- Bulky
- Cleaning of many parts
- Can be noisy
- Require power outlet

2. Mesh Nebulizers

Benefits

- Portable
- Silent
- Operates at all angles
- Simple one-button operation

Disadvantages

- Relative high costs
- Thorough cleaning is required, especially the mesh element

3. Ultrasonic Nebulizers

Benefits

- Quiet and easy operation
- High output (‘nebulization rate’) ~ up to 10 times as compared to Compressor Nebulizer

Disadvantages

- More expensive than a Compressor Nebulizer
- Not possible to nebulize suspensions (e.g. Pulmicort) and medications with higher viscosity
- Some medications (e.g. antibiotics), may change in quality, due to high ultrasonic energy
- Requires AC power
- In addition to the medication, water is required for cooling

Distilled water or purified water cannot be used alone as a drug solution for nebulization.

1. Median Mass Aerodynamic Diameter (MMAD µm)

Nebulizers create aerosol droplets with a range of particle size diameters, and MMAD is the diameter that divides the mass of an aerosol in half. MMAD is one of the recommended parameter from European Respiratory Society for measuring nebulizer performance.

Upper Airways:

Chronic – Allergic Rhinitis (Hay Fever)

Infections – Rhinitis (Common Cold), Sinusitis, Laryngitis 

Lower Airways

Chronic – Asthma, COPD

Infections – Bronchitis, Bronchiolitis, Pneumonia

2. Speed

Higher nebulization rate = Shorter treatment time

Nebulization rate is the amount of nebulized medication in ml coming out of the nebulizer per minute.

3. Aerosol Output

Amount of medication deposited in the lungs. It is measured using a breath simulator pump connected to a filter (chemical analysis of NaF in the filter)

It is a key parameter of Nebulizer efficiency.

4. Noise Level

Babies and children may be fearful of the noise generated by compressor type nebulizers therefore a mesh or ultrasonic nebulizer may be more ideal.

5. Portability

Recommended for cases where on the go treatment is needed.
 

1. Who will be using the nebulizer?

Adults or Babies or Children

2. What is the condition?

Upper Airways or Lower Airways

Depending on the treatment area, the nebulizer should produce particle size to reach the targeted organ.

3. Where will the nebulizer be used?

At Home or On-The-Go

Compact and lighter nebulizers make it easy to have discreet treatments anywhere

Click here to find out more about Omron’s nebulizers.