Aerosol therapy mainly refers to aerosol inhalation therapy. The so-called aerosol refers to tiny solid or liquid particles suspended in the air. Therefore, the atomization inhalation therapy uses an atomization device to disperse the drug into tiny mist droplets or particles, which are suspended in the gas and enter the respiratory tract and lungs to achieve clean airways, humidified airways, local treatment and whole body. Purpose of treatment.
Nebulization treatment
Aerosol therapy
Maintaining the stability of the water droplet itself is the premise of the atomization treatment, and the main factors affecting its stability:
Volume and properties of water droplet particles;
particle concentration;
Air humidity.
Stable conditions: 0.3-0.7 m in diameter, 100-1000 / L in concentration. Generally, the atomizer produces a diameter of 0.5-3 m.
First, the nature of the mist particles
The physical mechanisms that cause mist deposition are:
Impact deposition.
gravity deposition.
diffuse deposition.
Intercept deposition.
Static attraction deposits.
The relationship between the diameter of the mist particles and the deposition site:
Particle volume (diameter)
Deposition site
Main deposition method
> 10
Oral cavity (external chest area)
Impact deposition
5-10
Trachea and 2 trachea trees (trachea and trachea area)
Usage: Aerosolized inhalation, which usually takes effect within minutes, and the effect can be maintained for several hours. It is the drug of choice for alleviating the symptoms of mild to moderate acute asthma.
Salbutamol: 100-200 g each time inhalation of asthma, or 250-500 g terbutaline, repeat every 20 minutes if necessary. Patients who are not satisfied with the effect after 1 hour should consult a doctor or go to the emergency department.
2. Influenza, common cold, and acute rhinitis:
formula:
1. White vinegar 5ml + physiological saline to 10ml;
3. Acute: Pharyngitis, Laryngitis, and Bronchitis:
formula:
1. Gentamicin 80,000 units + dexamethasone 5mg plus normal saline to 16ml;
2. Chloramphenicol 0.3g plus normal saline to 15ml;
3. Add erythromycin 0.3g to 15ml.
Usage: Aerosolized inhalation, 1-3 times a day, a course of 3-5 days. Symptoms should be reduced after remission, and the drug should be discontinued after 2-3 days. In severe cases, other treatments should be used.
1. Gentamicin 80,000 units-15mg of protease plus 15ml of normal saline;
2. 20% sputum is easy to clean 10ml + aminophylline 0.25g.
To use: Nebulize and inhale 1-2 times daily for 10-15 minutes each time.
First, the atomizer
1. Small volume nebulizer (SVN) is also called spray atomizer, manual atomizer, medical atomizer or wet atomizer. It is currently the most commonly used aerosol generating device in clinical practice. Working principle: compressed air (
Small dose nebulizer (SVN)
Larger doses can be given continuously or multiple times; fewer patients need coordinated breathing movements; freon is not needed as a booster.
Nebulizers are easily contaminated, causing cross-infection and nosocomial infections; expensive; serious inhalation of inhaled medications; there are certain options for inhaled medications; high-pressure airflow is required as power; longer treatment times.
MDIs
Convenient and cheap.
Patients need to coordinate breathing movements; oropharyngeal aerosol sedimentation is more difficult to deliver larger drug doses; there are certain options for drugs; patients may be abused; Freon is used as a booster.
MDIs plus mist reservoir
Patients need less coordination in breathing; less aerosol sedimentation in the oropharynx; increased efficacy of nebulized inhalation.
Mist accumulators are inconvenient to carry; it costs more than using MDIs alone.
Dry powder inhaler
Patients need less coordination of breathing; patients start spraying on breathing; freon is not needed as a booster.
Requires higher inspiratory airflow; drugs have a certain selectivity; cannot be used for patients with mechanical ventilation; difficult to deliver larger drug doses.
Obstructive airway disease
Aerosol inhalation therapy can be used to prevent airway obstructive diseases. Among them, nebulized inhaled adrenocortical hormones, antiallergic drugs, etc. are mainly preventive drugs; inhaled beta adrenergic agonists and anticholinergic bronchodilators are only required for therapeutic drugs.
