Selection And Use Of Children's Nebulizers

Aerosol inhalation drug therapy is a common treatment method for children with wheezing disease or acute asthma attacks, and its curative effect is rapid and reliable. Children with asthma can also be given short-term aerosol inhalation therapy if wheezing occurs again after long-term standardized treatment is discontinued.

First, the principle of atomization inhalation

Atomization inhalation is the sudden decompression of the gas through the narrow opening, and the negative pressure generated locally sucks the liquid medicine and forms mist particles. Direct inhalation through the mouth and nose into the respiratory system is more effective than oral/injection. The size of the drug mist particles is 2-5um, which can be well deposited in the small airways and play a therapeutic role.

Second, the type of atomizer

There are currently three types of atomizers on the market: ultrasonic atomizers, compression atomizers, and micro-mesh atomizers. Their difference is mainly in the atomized particle size.

Ultrasonic atomizer: The amount of atomization is large, but the atomized particles are also relatively large. Generally, the MMD (median particle size) is about 9 microns. It cannot enter the lower respiratory tract, so it is generally suitable for upper respiratory tract treatment.

Compression nebulizer: The atomized particles are small, and the MMD is generally within 5 microns, which can be deposited in the lower respiratory tract, and is generally suitable for the treatment of the lower respiratory tract.

Micro-mesh nebulizer: The atomized particles are smaller, generally within 3 microns of MMD, and can be deposited in the lower respiratory tract, peripheral bronchi, and alveoli. Therefore, for children, it is recommended to use a micro-mesh nebulizer. The respiratory tract of children is relatively narrow, so in order to send the drug into the bronchi, the use of a micro-mesh nebulizer is a better choice.

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3. How to choose an atomizer

When choosing an atomizer, be sure to consider several issues:

1. Look at the size of the atomized particles: if the particles are too large, they cannot enter the lower respiratory tract and cannot have a therapeutic effect.

2. Noise: The noise level of the atomizer is an important indicator of its quality. Children who are too loud will not accept it.

3. Vibration: Vibration is accompanied by noise. Generally speaking, if the noise is large, the vibration must not be small.

4. Heat generation: Machines with large noise and vibration must generate a lot of heat, resulting in energy loss. The nominal power of the compression atomizer is not as large as possible. A machine with a lot of power but a lot of noise (vibration, heat), most of its energy is wasted.

5. Portability: When used for home use, the size of the atomizer is also a factor that home users need to consider. Smaller size means more convenient portability.

6. Atomizing cup: After the compressor meets the basic requirements, the quality of the atomizing cup is particularly critical. This information can generally be obtained from the product packaging.

Fourth, the choice of drugs for aerosol inhalation

There are four types of drugs that can be used for nebulization:

Beta2-agonists, such as salbutamol solution (or terbutaline nebulized suspension);

Anticholinergic drugs: ipratropium bromide nebulizer solution;

Surface corticosteroids: budesonide nebulized suspension;

Combination: Compound ipratropium bromide (ipratropium bromide and albuterol).

For reasons of efficacy and safety, aerosol inhalation is not recommended for other drugs. Since some nebulized inhaled drugs are insoluble suspensions in water, ultrasonic nebulizers cannot be used for the inhalation of drugs.

5. Dosage of aerosol inhalation drugs

Nebulized inhalation drugs can act on the lungs quickly and directly at high concentrations, with high local drug concentrations and rapid and reliable curative effects. Because children metabolize drugs faster than adults, and young children metabolize drugs faster than older children, the number of drugs inhaled into the lungs is directly related to age. The younger the age, the less the amount of drugs inhaled into the lungs. Therefore, it is generally not necessary to calculate the dose of inhaled therapeutics based on body weight. In the case of inhalation, salbutamol solution (2.5-5mg) and budesonide suspension (0.5-1mg) is usually used at the same time for a better curative effect. It can be directly atomized and inhaled without dilution, or it can be diluted with 2ml of physiological saline according to the situation. Generally, it can be atomized and inhaled 2 to 3 times a day.

Precautions

When atomizing inhalation, you need to pay attention to thoroughly wash your hands before preparing or taking the medicine. After receiving the atomization, rinse the mouth, mask, and some accessories of the dosing with clean water, and regularly use a special needle to unblock the nozzle.

After cleaning and unblocking the nozzle, it can be sprayed with normal saline for at least 5 minutes, and the mouth, face mask, etc., can be soaked in the disinfectant for disinfection.

Infants and young children are given medicine with a mask. The mask should be closed to the mouth and nose. Children over 3 years old should try to use the door to inhale the medicine.