Nebulizer

Nebulizer

In the medical field, a nebulizer (also spelled nebuliser in British English) is a device utilized to administer medication in the form of a mist that is inhaled into the lungs. Nebulizers find common application in the treatment of conditions such as cystic fibrosis, asthma, COPD, and various other respiratory ailments.
Nebulizers employ oxygen, compressed air, or ultrasonic power to disperse medical solutions and suspensions into minute aerosol droplets that can be directly inhaled through the device's mouthpiece.

An aerosol is defined as a "mixture of gas and liquid particles," with mist being a prime example of a naturally occurring aerosol. Mist forms when small water vapor particles in hot ambient air cool and condense into fine visible airborne water droplets.
During inhalation therapy with a nebulizer, it's essential to note that aerosol droplets must have a diameter of 1-5 micrometers to penetrate into the narrow branches of the lower airways effectively. Otherwise, they are only absorbed by the oral cavity, resulting in diminished effectiveness.

The most prevalent type of nebulizers is Jet nebulizers, often referred to as "atomizers." These nebulizers are linked to a compressor via tubing, which generates compressed air or oxygen flow at high velocity through a liquid medication to produce an aerosol, subsequently inhaled by the patient. While there's a growing preference among physicians for prescribing pressurized Metered Dose Inhalers (pMDI) over Jet nebulizers due to their quieter operation and lighter weight, Jet nebulizers remain widely used in hospital settings, especially for patients facing challenges with inhaler use, such as in severe respiratory diseases or asthma attacks.

Jet nebulizers offer the advantage of low operational costs. For patients requiring daily inhalation therapy, the expense of using a pMDI can be considerable. Some manufacturers have succeeded in reducing the weight of Jet nebulizers to as low as 635 grams (22.4 oz), labeling them as portable devices. However, despite advancements, noise and weight remain significant drawbacks of Jet nebulizers compared to other inhalers and nebulizers.

Nebulizers administer medication in the form of a liquid solution, typically loaded into the device before use. Corticosteroids and bronchodilators like salbutamol (albuterol USAN) are commonly utilized, sometimes combined with ipratropium. Inhaling these medications targets their effects to the respiratory tract, hastening onset of action and reducing side effects compared to alternative intake routes.

The aerosolized medication is usually inhaled through a tube-like mouthpiece, akin to inhalers. Alternatively, a face mask similar to those used for inhaled anesthesia may be used, especially with young children or the elderly, although mouthpieces are preferred when feasible to minimize aerosol losses in the nose.

After corticosteroid use, patients may theoretically develop thrush (yeast infection in the mouth) or dysphonia (hoarseness of voice), though these occurrences are clinically rare. To mitigate these adverse effects, clinicians may advise patients to rinse their mouths after nebulizer use. This isn't necessary for bronchodilators, though patients may still opt to rinse due to the unpleasant taste of certain bronchodilating drugs.