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Everyone should have a nebuliser at home, especially in the era of the COVID-19 epidemic – such opinions can be found on the Internet. Pulmonologist dr hab. Tadeusz Zielonka warns, however: in the current epidemic situation, nebulization is a dangerous form of drug administration. Why? What is a nebulizer, in what diseases does it help? In what situations is it currently used and how? We explain.
- Nebulization is a type of inhalation treatment, it is a completely painless and non-invasive procedure
- The nebulization procedure is used in various diseases of the respiratory tract – asthma, COPD, chronic respiratory tract infections, troublesome cough, blocked nose, pharyngitis or laryngitis.
- Nebulization during the coronavirus epidemic. “In the present situation, it is a dangerous form of drug administration, as it increases the risk of spreading the infection” – warns Tadeusz Zielonka
- For more up-to-date information about the epidemic, please visit the TvoiLokony home page
Nebulizer: what is it, in what diseases it is used
Before explaining what a nebulizer is, let’s explain what it is: nebulization. This term means the administration of a drug which, in the form of an aerosol or mist, gets directly into the patient’s respiratory tract (the word comes from the Latin word: nebula, i.e. fog). The nebulizer makes this application possible.
This device sprays the healing agent. The resulting mist (in which the drug particles are suspended) is inhaled through a mask or mouthpiece. Nebulization is therefore a kind of inhalation treatment, it is a completely painless and non-invasive procedure.
Depending on the size, the inhaled particles reach different areas of the respiratory tract. The largest (with sizes ranging from 20–100 μm) are retained in the nose, mouth and pharynx, the smaller ones (6–12 μm) are deposited in the trachea and bronchi, and particles with a size of 1–5 μm reach the alveoli.
- Everything you need to know about the respiratory system
As you can see, thanks to the drug reaching the affected areas of the respiratory tract directly, its action is faster and more effective. What’s more, nebulization allows you to achieve a high concentration of the preparation in the respiratory tract, which also translates into its effectiveness. Therefore, it is possible to reduce the dose of the drug and thus reduce the risk of possible side effects.
The nebulization procedure is used in various ailments of the respiratory tract – asthma, chronic obstructive pulmonary disease (COPD), emphysema, cystic fibrosis, and chronic respiratory tract infections. Nebulization may be an adjunct therapy in acute diseases of the lower respiratory tract.
Nebulization can be performed in a hospital setting or at home (it is often used in the case of a nagging cough, blocked nose, pharyngitis or laryngitis).
Nebulizer and inhaler – what are the differences, types of nebulizers
Let’s start by distinguishing between the terms: inhalation and nebulization – often treated as synonyms. Meanwhile, nebulization means inhaling the cool mist containing the drug, while inhalation means inhaling the hot vapors of the vaporizing medicinal preparation.
The names nebulizer and inhaler are also interchangeable, yet they are two different devices. How are they different from each other?
The principle of their operation is similar, and both create a healing mist which, when inhaled, enters the patient’s respiratory tract. However, inhalers are usually small containers with medicine that we can always have with us and use when the need arises (inhalation takes a few seconds). Nebulizers are larger, reusable devices that run on electricity or batteries. In their case, inhalation takes longer – until the drug in the device’s container is exhausted.
There are also differences in the way of use. When taking the medicine from the inhaler, we need to coordinate the inhalation with the spraying of the dose. It is not necessary in the case of a nebulizer – here it is enough to simply breathe freely (thanks to this, nebulization can be successfully used in small children, the elderly or uncooperative patients). In nebulization, we use only preparations intended for this type of treatment – always after consulting a doctor.
Nebulizers come in three types, differing in the method of drug application. We have pneumatic nebulizers that use compressed air in a compressor to produce an aerosol. There are mesh nebulizers – they use vibrations to produce an aerosol caused by the drug being forced through mesh grilles. The third type are ultrasonic nebulizers, which use the ability of the ultrasonic head to generate an acoustic wave that allows the generation of an aerosol.
The nebulizer can also combine in one device with a coflator, which supports breathing and helps to get rid of secretions from the respiratory tract. Check out the offer of the Philips Respironics CoughAssist E70 Cough Assistant.
Nebulization – disadvantages, contraindications to use
Nebulization, as we’ve already mentioned, has many advantages. This does not mean, however, that this method of drug administration is free from disadvantages. One of them is the need to learn how to use the device and the inhalation technique itself.
It is also worth knowing that not everyone can use this treatment. Contraindications to nebulization in diseases of the lower respiratory tract include: severe heart failure, chronic severe respiratory diseases (tuberculosis, cancer), respiratory haemorrhage.
A very important issue regarding nebulization is its use during the SARS-CoV-2 coronavirus epidemic. On the Internet, you can find information that everyone should now have a nebuliser (due to possible respiratory symptoms). Is it really so? We asked Dr. hab Tadeusz Zielonka, specialist in lung diseases and internal diseases.
Nebulization during the COVID-19 epidemic. Doctor: increases the risk of spreading infection
– There are recommendations to limit the use of nebulization during the coronavirus pandemic. In the present situation, it is a dangerous form of drug administration, as it increases the risk of spreading the infection – warns Tadeusz Zielonka.
Why can nebulization promote the spread of the pathogen? – When a person suffering from COVID-19 uses nebulized drugs, the aerosol exhaled by them contains very large amounts of the virus, which pose a risk of infecting people at home – explains the specialist. All because nebulization promotes the spread of the coronavirus in the air – along with the exhaled aerosol. – In addition, the spread of aerosols in the room increases when a patient with COVID-19 sneezes or coughs during the procedure – adds our expert.
It is also recommended to limit the use of nebulization in hospitals as it may lead to infections of white personnel. – Of course, there are people for whom this procedure is the only possible form of treatment, e.g. in the case of a bedridden elderly patient or a child who are not able to inhale the medicine themselves. In this situation, you cannot give up on it, but we are obliged to apply the necessary protection measures – says Dr. Zielonka. – Before the procedure, we post a message so that no one can enter the room after connecting the camera. After nebulization, the room is ventilated and disinfected, and the personnel must use masks with antibacterial filters.
Similar rules apply when carrying out nebulization at home. – If the doctor decides that nebulization is necessary, we are obliged to take special precautions – emphasizes the expert.
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