A nebulizer is a medical device that is used by patients in a condition that requires the delivery of atomized particles (aerosol) of drugs to the airways. The anatomy of the airways caused particles to be filtered out before they reach the lungs, but small particles between 1 and 7 µm in diameter will reach the relevant parts more effectively.
Therefore, selecting the most appropriate device for drug delivery is very important for optimal results. Increase in efficiency of drug delivery means that the medication will act faster and at a lower dosage which will reduce the incidence of side effects.
Types of nebulizer
There is a variety of nebulizers and each of them has unique features although they function similarly. Generally, there are three types of electronic nebulizers: the compressor nebulizer, the ultrasonic nebulizer, and the mesh nebulizer. The type of nebulizer chose will influence treatment duration, particle size, portability, durability and many other aspects of the therapy. Whereas ultrasonic nebulizers are used in professional settings, compressor and mesh nebulizers are the one to be considered for home use:
Compressor Nebulizers – The compressor nebulizers is powered by a compressed gas that flows at high velocity through the liquid medicine to turn it into aerosol form. These are less expensive and offers a range of particle sizes output. Also known as tabletop nebulizers, they are heavy and are not meant to be carried around. They may be more suitable for those who prefer stationary use. They require an electric outlet for operation and have a tendency to be a little noisy.
Mesh Nebulizers – The mesh nebulizers use electricity or ultrasonic wave and the liquid drug is forced through a vibrating mesh/membrane with laser drilled hole, producing very fine droplets through the hole. It is considered as the fastest working device and is more expensive compared to the others. It operates on a battery power supply quietly and efficiently. Given it handheld function, it’s ultra compact and portable compared to compressor nebulizers.
Choosing the right nebulizer
Although your healthcare provider will recommend a suitable nebulizer for your medication administration, you may still have choices when it comes to brand, size, and other options. Give yourself ample time to search for the optimum choice as the nebulizer will be an investment in your health and wellness.
Hence, bear in mind all these factors before making your decisions:
Compatibility with the medical condition
The choice of the device should be tailored to your condition. Different diseases require a different intervention. Upper respiratory diseases such as common cold may require larger particle size while lower respiratory diseases as COPD require smaller particle size. For example, compressor nebulizer offers a range of particle size while mesh nebulizer offers consistent particle size.
Meanwhile, for the patients suffering from multiple respiratory diseases, a nebulizer that delivers different, adjustable particle sizes will be a convenient solution. Ask your healthcare provider for suitable nebulizer recommendation that delivers the right particle size for your underlying condition.
Age, physical & cognitive ability of patients
Elderly and infant may have a limited ability to operate devices. Cognitive decline in elderly means that more complex maneuvers with handheld devices will be challenging. Similar situations arise in those with arthritis, failing eyesight, reduced inspiratory flow and complex treatment regimens. For those with limited abilities to adopt complex inhalation technique, it’s might be better to choose simple compressor nebulizer. Your healthcare providers should be made aware of emerging problems, including dexterity or cognitive decline.
If you’re shopping for your child, nebulizer with low noise and gentler mist will be a more convenient option. You may look for a versatile model with optional, child-friendly accessories. There are also colorful options available for kids. Choose a nebulizer that is practical for you as a caregiver. If your child or loved one requires nebulizer therapy, it’s also important that other caregivers who might administer treatment understand how to properly use a nebulizer.
Efficiency of device
Your healthcare provider will recommend a nebulizer that is most efficient for your use. Know that certain medications work best with specific types of nebulizers, and some medications have limitations for which nebulizers they can be used with. Also, keep in mind that the therapy is only effective if the device is operated correctly. Make sure your ability to use the nebulizer is assessed by a competent healthcare professional. If you are unable to use the device properly, discuss with your healthcare provider for an alternative. If your child is using the nebulizer, ensure that your healthcare provider periodically re-evaluates to ensure the most appropriate aerosol device is being used as your child grows.
It is important to opt for a device that is easy to use according to your lifestyle. If you are constantly on the go, consider purchasing mesh nebulizer and the necessary accessories like power supplies to carry with you. On the other hand, stationary compressor nebulizers may suit as a good aid for usage by children or elderly or if you are more homebound.
Some people prefer to purchase both types of nebulizers. If you’re unsure of which type to purchase, it might be best to go with mesh nebulizer for greater convenience.
When and where the aerosol therapy is required can also impact device selection. Therapy that is given routinely, once or twice a day does not need to be as portable as medication administered more frequently or rescue medications that may be required at any time.
In environments where you are in close proximity to other people, you may prefer a device with the least noise and treatment time. You should also choose devices that limit or filter exhaled aerosol to avoid secondhand exposure to aerosols.
Multiple dose convenience
Many patients are prescribed more than one inhaled drug. To avoid confusion as to how to use each device for each medication, ask your healthcare provider to suggest a nebulizer that suits all of your medication. Using the same device or decreasing the number of different devices will make you adhere more to therapy while minimizing the confusion caused. Although nebulizers allow multiple separate drugs to be inhaled at the same time, do not combine medication unless they are known not to negatively impact each other.
Ensure that the nebulizer you choose is of good durability so that it can withstand rigorous use and daily cleaning procedures. If you are unwilling to routinely clean and maintain the device, nebulizers that require extensive cleaning are not a good choice for you. Nebulizers last longer when properly cared for which also involves checking the air filter frequently and changing it when necessary. If it proved too much for you, you may choose a device with least maintenance or a disposable nebulizer instead.
Cost & reimbursement
A nebulizer is a long-term investment for your health, so you should make the most out of your budget. It is very important to select an aerosol device that is the least out-of-pocket expense but still effective. Check your medical insurance status if you can get covered for a nebulizer.
If you purchase your nebulizers online, try to order all the accessories you need at once to save money on shipping. You can also look for special prices and shipping promotions. If the best device is not one that you could afford, discuss with your doctor for an affordable option.
Find out what types of nebulizer accessories you need or prefer. Does your child prefer face mask or mouthpiece? Some people do not prefer the salty sensation felt through medication given by mouthpiece. If you choose to use a mask for your child, there are cute mask options that help them feel more welcomed for the routine.
Replacing accessories and filters on time will help make your nebulizer system last longer, which saves you money in the long run. Nebulizer masks come in a variety of sizes. You’ll need to find out what size you need to replace before placing an order. Also, know what types of filters, medication cups, and parts you need for your specific nebulizer.
It is reported that many patients poorly understand the principles of nebulizer treatment and are unaware when nebulizer malfunction. Therefore, continuous education with your healthcare professional is important in choosing and maintaining the usage of the suitable nebulizer for you.
Review Date: July 23, 2018 | Last Modified: July 23, 2018
“Nebulisers: Their Effectiveness, Indications and Limitations - Johns - 2007 - Prescriber - Wiley Online Library.” Accessed May 30, 2018. https://onlinelibrary.wiley.com/doi/abs/10.1002/psb.18.
Ari, Arzu, and James B. Fink. “Guidelines for Aerosol Devices in Infants, Children and Adults: Which to Choose, Why and How to Achieve Effective Aerosol Therapy.” Expert Review of Respiratory Medicine 5, no. 4 (August 2011): 561–72. https://doi.org/10.1586/ers.11.49.
Dolovich, Myrna B., Richard C. Ahrens, Dean R. Hess, Paula Anderson, Rajiv Dhand, Joseph L. Rau, Gerald C. Smaldone, Gordon Guyatt, American College of Chest Physicians, and American College of Asthma, Allergy, and Immunology. “Device Selection and Outcomes of Aerosol Therapy: Evidence-Based Guidelines: American College of Chest Physicians/American College of Asthma, Allergy, and Immunology.” Chest 127, no. 1 (January 2005): 335–71. https://doi.org/10.1378/chest.127.1.335.
Myers, Timothy R. “The Science Guiding Selection of an Aerosol Delivery Device.” Respiratory Care 58, no. 11 (November 2013): 1963–73. https://doi.org/10.4187/respcare.02812.