Inhaler – which is better?

What is an inhaler? It is a medical device for nebulizing drugs in the form of an aerosol that a patient with lung problems inhales to treat asthma, bronchitis, cystic fibrosis, COPD and other diseases. There are two main types of inhalers: 1) compressor nebulizers (eg OMRON) and 2) ultrasonic inhalers or ultrasounds (eg Monsoon). At first glance, it seems, and many doctors convince that it doesn’t matter which inhaler to use. But the sellers and manufacturers of nebulizers, those who would like to buy an inhaler, are strongly advised to buy only their products, scolding ultrasound for what the world is worth. So what is the truth?
First, you should understand the principle of operation of both inhalers. The nebulizer atomizes the drug solution using compressed air, which is supplied from the compressor to the nebulizer head through the smallest opening. Simply put, a nebulizer works like a sprinkler. And small aerosol droplets are formed by passing through a hole of the smallest diameter. Therefore, the size of the nebulizer droplets does not exceed 0.5-1 micron. And this is what manufacturers are trumping, claiming that particles of this size penetrate literally into the most inaccessible parts of the bronchial tree in the lungs.
Unlike a nebulizer, an ultrasonic inhaler “breaks” the solution into tiny particles using an ultrasonic element built into the bottom of the medicine container. And these particles have a size of 0.5 to 5-10 microns. That is, unlike a nebulizer, aerosol particles from ultrasound have different sizes. Nebulizer manufacturers see this as a disadvantage, and capitalizing on this fact, they advertise it as an advantage of their rattling devices. It is rattling, because the nebulizer compressor is very noisy. Unlike silently working ultrasound. But back to the particle size that is so praised by the sellers of nebulizers. In fact, it turns out that only those aerosol particles that exceed the size of 0.5 microns are 100% deposited in the lungs, so almost 75% of the drug is exhaled into the atmosphere. True, in some models of nebulizers, the particle size can be adjusted upwards, but at the same time they “merge” into drops and are simply swallowed by the patient. When conducting inhalations on ultrasound, large particles – 10 microns settle in the large bronchi, medium – 5 microns in the middle bronchi, small – 1-2 microns in the small bronchi, and only smaller particles fly back into the atmosphere. And the most important advantage of ultrasound over nebulizers lies in performance: they are able to spray large volumes of medicinal solutions in one minute – from 1 to 6 ml, while the performance of nebulizers does not exceed 0.5 ml per minute. The surface area of the bronchial tree can reach in different patients (depending on age, height and weight) from 5 to 10 square meters. m. And of course, it is impossible with the help of a low-power rattling nebulizer to treat this surface with 1-3 ml of the poured solution. Therefore, these rattles are mainly used for inhalation of small amounts of bronchodilator drugs, such as, for example, Berodual .

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