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Use of medication nebulizers in children

INTRODUCTION

The delivery of aerosolized medication is an important component of treatment for many respiratory disorders, and is a critical aspect of asthma management in children. Corticosteroids, bronchodilators, antibiotics, and mucolytic agents can be administered via aerosol.

Nebulizer devices are widely used to deliver aerosol therapy, especially in children. A wide variety of nebulizers is available for use in the home and hospital, with varying capacities to deliver drugs to the lungs [1]. Clinicians must consider how a particular nebulizer performs with the specific drug to be administered to ensure its acceptability in the clinical situation for which it is prescribed [1-4].

The use of medication nebulizers in children will be presented here. An overview of aerosolized medication delivery in children, and the use of pressurized metered dose inhalers are discussed separately. (See "Delivery of inhaled medication in children" and "Use of metered dose and dry powder inhalers in children".)

INDICATIONS

Nebulizers may be used to provide aerosol therapy to patients too ill or too young to use hand-held devices, and in situations where large drug doses are necessary. These devices also are required for some medications available only in liquid form, including pentamidine, ribavirin, rhDNAase, and tobramycin.

The potential benefits of nebulizers need to be balanced with the disadvantages associated with the use of these devices. These include higher costs, longer setup and delivery time, decreased portability, variable nebulizer performance, and (with jet nebulizers) the need for a source of compressed air or oxygen.
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