What is nebulization inhalation therapy
Nebulization inhalation therapy is a treatment method that uses the principle of gas jet to suspend tiny droplets of water that are impacted by water droplets in the gas, forming an aerosol and entering the respiratory tract for respiratory humidification or drug inhalation. It serves as an auxiliary and supplementary treatment for systemic therapy. Due to the large contact surface of aerosols, it is beneficial for drugs to come into contact with the mucosal epithelial cells on the airway surface and exert their therapeutic effects. Inhalation therapy is currently the preferred method of administration for asthma treatment.
Nebulizer inhalation therapy for children is an important treatment for respiratory system related diseases. It has multiple advantages compared to oral, intramuscular, and intravenous injections: the drug acts directly on the target organ, takes effect quickly, has good therapeutic effects, has fewer systemic adverse reactions, and does not require deliberate cooperation from the patient.
Common nebulization inhalation methods
1. Types of nebulized inhalers
2. Usage of different atomizers
(1) Quantitative inhaler:
Generally used for children aged 2-4 who have long-term recurrent wheezing and require inhalation. The advantage of this inhaler is that it is easy to carry and can be sprayed in the morning and evening to solve the problem. However, due to the young age of children in this age group, it is difficult to cooperate, so we recommend adding a fog storage canister when using this inhaler.
(2) Mist storage device
(3) Accurater
3. Commonly used nebulization inhalation devices in clinical practice
(1) Type:
The commonly used nebulization inhalation devices in clinical practice are divided into three types: jet nebulizers, ultrasonic nebulizers, and vibrating mesh nebulizers.
(2) Advantages and disadvantages:
It should be noted that ultrasonic nebulization inhalation therapy is not suitable for the treatment of asthma.
Because: the drug mist particles cannot fully reach the top layer of the liquid surface where mist particles can form; Will increase airway resistance in asthma patients; Affects the activity of certain drugs; Insufficient drug atomization results in a small number of effective drug mist particles.
4. How to choose an ideal inhalation device
An ideal inhalation device should have the following characteristics:
√ High stability of dose output to the lungs at various inhalation flow rates;
√ Small particle diameter (1-5 microns);
√ Easy to use;
√ The device has a small volume and is easy to carry;
Can be used for different doses of drugs;
√ Economy;
√ Countable.
5. Inhalation devices suitable for patients of all ages
<2 years old - Nebulized inhalation or MDI+mist storage tank with face mask;
<4 years old - nebulized inhalation or MDI+mist storage tank;
≥ 4 years old - can try dry powder inhaler (inhaler);
>7 years old - MDI, but often has technical errors, detailed guidance should be provided.
Common nebulized inhalation drugs
1. Inhaled corticosteroids ICS:
The domestically available nebulized dosage forms of ICS include budesonide (BUD) and beclomethasone dipropionate (BDP).
2. Bronchodilator:
Including short acting selective beta 2 receptor agonists (SABA) such as terbutaline and salbutamol;
3. Antibacterial drugs:
At present, there are no antibacterial drug preparations specifically designed for nebulization inhalation in China, and it is not recommended to use intravenous preparations instead of nebulization preparations.
4. expectorants:
Including N-acetylcysteine and ambroxol hydrochloride, but the nebulized form of ambroxol hydrochloride has not yet been launched domestically.
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Parents may ask: Is nebulized inhalation of steroid drugs unsafe? Will it affect the growth and development of children?
In fact, the adverse reactions of nebulized inhalation of corticosteroids ICS are rare in clinical practice. Research has shown that compared to placebo, the risk of systemic adverse reactions (growth retardation, adrenal suppression, cataracts, decreased bone density, and fractures) during long-term maintenance treatment with ICS is not increased. Even after 7-11 years of ICS treatment, asthmatic children can still achieve normal adult height. During long-term nebulization of ICS, the medication should be adjusted to the minimum effective maintenance dose in a timely manner to further improve safety.
Application of nebulized inhalation in pediatric clinical practice
What situations require nebulization therapy?
>Bronchial asthma
>Cough variant asthma (CVA)
>Cough after infection (PIC)
>Infant wheezing
>Mycoplasma pneumoniae pneumonia
>Acute laryngotracheitis
>Bronchopulmonary dysplasia (BPD)
>Intraoperative and postoperative endotracheal intubation
>In the treatment of home nebulized inhalation of glucocorticoids
2. Main treatment measures for acute asthma attacks
1) Relieve airway spasms:
Inhale fast acting β 2 receptor agonists, aminophylline, and magnesium sulfate.
2) Active anti-inflammatory treatment:
Adrenal glucocorticoids can be used.
3) Other measures:
Oxygen inhalation, removal of triggers, prevention of infection, dilution of phlegm solution and sputum discharge, correction of electrolyte imbalance (pay attention to electrolyte supplementation and low potassium), sedatives, etc.
3. Bringing home nebulization therapy has many benefits
For many children who need to do atomization for a long time, we still recommend buying an atomizer and doing atomization themselves at home. Why? Because doing nebulization at home is beneficial for both children, parents, and doctors.
Summary
>Compression pump atomization can make drug particles meet the treatment requirements of the lower respiratory tract.
>Dexamethasone cannot be used as a nebulized medication.
>Inhaling hormones can treat various pediatric diseases.
>Inhaling hormones is safe and effective.
>Home atomization is safe, effective, and economically convenient.
I believe that after completing this micro lesson, all parents have gained a certain understanding of nebulization inhalation therapy.