Browse the corpus

©2013 UpToDate ® Print Email Advantages and disadvantages of various aerosol devices Type Advantages Disadvantages Jet nebulizer* Patient coordination not required High doses possible Generally more expensive than metered dose inhaler More time required Contamination possible Device preparation required before treatment Not all medications available Less efficient than other devices (dead volume loss) Mesh nebulizer (eg, Aeroneb ® , eFlow ® , Omron MicroAir ® , I-neb) Patient coordination not required High doses possible Quiet Faster delivery than jet nebulizer More accurate delivery of desired dose than jet nebulizer Portable, battery operated Expensive Contamination possible Device preparation required before treatment Cleaning required after dose Not all medications available Ultrasonic nebulizer (eg, OPTI-NEB™, Beetle Neb, Lumiscope, MiniBreeze) Patient coordination not required High doses possible Small dead volume Quiet No drug loss during exhalation Faster delivery than jet nebulizer Expensive Contamination possible Prone to malfunction Device preparation required before treatment Cannot use with medications in suspension (eg, budesonide) Metered-dose inhaler Convenient Less expensive than nebulizer Portable More efficient than nebulizer No drug preparation required Difficult to contaminate Patient coordination essential Patient actuation required Large pharyngeal deposition Difficult to deliver high doses Not all medications available Metered-dose inhaler with holding chamber Less patient coordination required Less pharyngeal deposition More expensive than MDI alone Less portable than MDI alone Dry powder inhaler Less patient coordination required Convenient Propellant not required Portable Breath-actuated Requires moderate to high inspiratory flow Some units are single dose Can result in high pharyngeal deposition Not all medications available Difficult to deliver high doses Cannot use with endotracheal or tracheostomy tubes CFC: chlorofluorocarbon; MDI: metered-dose inhaler. * Many brands are commercially available in both disposable and non-disposable designs for use in the hospital and at home. Adapted from: Consensus Statement: Aerosols and Delivery Devices. Respir Care 2000; 45:589.