What is nebulized inhalation therapy

Nebulization inhalation therapy uses the principle of gas jet to suspend the tiny mist droplets impacted by water droplets in the gas to form an aerosol and enter the respiratory tract for respiratory tract humidification or drug inhalation. It is used as a supplement and supplement for systemic therapy. Because aerosol has a huge contact surface, it is conducive to the drug to contact the airway surface mucosal epithelial cells to exert the drug effect. Inhalation therapy is currently the preferred method of administration in the treatment of asthma.

Nebulizer inhalation therapy for children is an important treatment for respiratory system related diseases. Compared with oral, intramuscular injection and intravenous injection, it has many advantages: the drug directly acts on the target organ, the effect is rapid, the curative effect is good, the systemic adverse reactions are few, and the patient does not need to cooperate deliberately.

Common inhalation methods

1. Types of nebulizers

2. How to use different atomizers

(1) Metered-dose inhaler:

It is generally used for children who are 2 to 4 years old who have wheezing for a long time and need to inhale. The advantage of this inhaler is that it is easy to carry, and the problem can be solved by spraying it sooner or later. However, since children of this age group are relatively small and difficult to cooperate with, we recommend that you generally add a mist storage tank when using this inhaler.

(2) Fog storage device

(3) Admittance device

3. Nebulized inhalation device commonly used in clinic

(1) Type:

There are three types of inhalation devices commonly used in clinic: jet nebulizer, ultrasonic nebulizer, and vibrating mesh nebulizer.

(2) Advantages and disadvantages:

It should be noted that ultrasonic atomization inhalation therapy is not suitable for asthma treatment.

Because: the drug mist particles cannot reach the top layer of the liquid surface that can form fog particles; it will increase the airway resistance of asthma patients; affect the activity of certain drugs; the drug atomization cannot be sufficient, and the number of effective drug mist particles is small.

4. How to choose an ideal inhalation device

An ideal inhalation device should have the following characteristics:

√ Under various inhalation flow rates, the stability of dose output to the lungs is high;

√ Small particle diameter (1-5 microns);

√ Easy to use;

√ The device is small and 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-atomization inhalation or MDI+ mist storage tank with face mask;

<4 years old-atomization inhalation or MDI+ mist storage tank;

≥4 years old-you can try the dry powder inhaler (quasi-acceptor);

>7 years old-MDI, but there are often technical errors, detailed instructions should be given.

Common nebulized inhaled drugs

1. Inhaled glucocorticoid ICS:

The domestically available atomized dosage forms ICS include budesonide (BUD) and beclomethasone propionate (BDP).

2. Bronchodilators:

Including short-acting selective β2 receptor agonists (SABA), such as terbutaline and salbutamol;

3. Antibacterial drugs:

At present, there is no antibacterial drug preparation specially designed for nebulized inhalation in my country. It is not recommended to use intravenous preparations instead of nebulized preparations.

4. Expectorants:

Including N-acetylcysteine ​​and ambroxol hydrochloride, but ambroxol hydrochloride atomized dosage form has not yet been marketed in China.

Expert Q & A

Some parents will ask: Is it unsafe to inhale the hormone drugs? Will it affect the child's growth and development?

In fact, there are few clinical adverse reactions of nebulized inhaled glucocorticoid ICS. Studies have shown that compared with placebo, the risk of systemic adverse reactions (growth retardation, adrenal suppression, cataract, decreased bone mineral density, and fractures) of ICS long-term maintenance therapy has not increased, even after 7 to 11 years of asthma treatment with ICS Children can still reach normal adult height. When nebulizing ICS for a long time, the drug should be adjusted to the minimum effective maintenance dose in time to further improve safety.

Application of nebulized inhalation in pediatric clinic

1. In what situations does nebulization treatment need?

>Bronchial asthma

>Cough Variant Asthma (CVA)

>Cough after infection (PIC)

>Infant wheezing

> Mycoplasma pneumoniae pneumonia

>Acute laryngotracheobronchitis

>Bronchiopulmonary dysplasia (BPD)

>Intraoperative and postoperative tracheal intubation

>Home nebulized inhaled glucocorticoid treatment

2. The main treatment measures for acute asthma attacks

1) Relieve airway spasm:

Inhaled fast-acting β2 receptor agonist, aminophylline, magnesium sulfate.

2) Active anti-inflammatory treatment:

Adrenal glucocorticoids are available.

3) Other measures:

Oxygen inhalation, incentives to remove, prevent infection, dilute sputum and sputum discharge, correct water and electrolyte disorders (pay attention to electrolyte supplementation, pay attention to low potassium), sedatives, etc.

3. There are many benefits of taking atomization home

For many children who need to do atomization for a long time, we still recommend buying an atomizer to go home and do atomization by themselves. why? Because doing atomization at home is good for children, parents, and doctors.

Summary

> The atomization of the compression pump can make the drug particles meet the treatment requirements of the lower respiratory tract.

> Dexamethasone cannot be used as an aerosolized drug.

> Inhaled hormones can treat many pediatric diseases.

> Inhaled hormones are safe and effective.

> Household atomization is safe and effective, economical and convenient.

I believe that all parents have a certain understanding of atomization inhalation therapy after studying this micro-lesson.