In the healthcare setting a nebuliser is a small device that can convert a drug from a solution into an aerosol form by means of a compressor/compressed gas source.
Nebulisation creates a mist of drug particles that can be inhaled via a face mask or mouthpiece. Bronchodilators are the most common nebulised drugs but many others can be nebulised, including steroids and antibiotics.
HOW A NEBULISER WORKS
The conventional nebuliser works by a flow of gas (oxygen or air) passing through a very small hole (venturi). Rapid expansion of air causes a negative pressure that sucks the nebulised fluid up the feeding tube system where it is atomised and inhaled.
The proportion of the nebulised solution that reaches the lungs is approximately 12%, which is why nebulised doses of drugs are higher than those administered via an aerosol inhaler.
Medications that are commonly administered through a nebuliser include bronchodilators (for example, salbutamol), anticholinergics (for example, ipratropium bromide), corticosteroids (for example, beclometasone) and normal saline.
The main indications are delivery of:
- A bronchodilator or anticholinergic drug to a patient with an acute exacerbation of asthma or chronic obstructive airway disease (such as COPD);
- A bronchodilator or anticholinergic drug regularly to a patient with severe asthma or reversible airways obstruction in whom regular high doses have been shown to be beneficial;
- Prophylactic medication to a patient who has difficulty using other inhalational devices;
- An antibiotic to a patient with a chronic purulent chest infection;
- Pentamidine for the prophylaxis and treatment of pneumocystis pneumonia