Advantages of aerosoltherapy over oral treatment

aerosol

Aerosol

 

Rapid and direct access to the targeted organ

 

Increased efficiency

Smaller dose of the necessary medication

Low systemic route

Lower side effects

medicament

By Mouth

 

Indirect and slower

 

Medication distributed to all areas whether or not required thus the effects are systemically present.

Blood circulation


Indications

Asthma

Cystic fibrosis

COPD

Bronchitis

Winter ailments (bronchitis...)

ENT pathologies

Sinusitis

Rhinitis


From the really prescribed dose to the really effective mass

5 Keys to efficient treatment

The granulometric quality of the particules

Particle size and the deposition mechanism

 

The effect of the medication in the airways responds to various mechanisms and depends particularly on the size of the particles. To guarantee effective treatment medication particles must measure globally between 1µm and 5µm. In fact particles of greater size will be too large to penetrate the respiratory system and those of smaller size fail to reach their target and will be evacuated on exhalation.

Deposition of inhaled particules : 3 things which depend in part on the size of the produced particles
MMAD

 

MMAD

 

MMAD is a unit of measure expressed in µm which provides for granulometric quality in an aerosol generator. It concerns Mass Median Aerodynamic Diameter relating to the diameter of particles such that half of the mass produced by the aerosol consists of smaller particles and the other half is of particles greater than this diameter.

 

Impaction

Large particles [dia ≥ 5µm]

The large particles propelled by their volume in the gaseous flow collide with the walls and turnings. They are therefore largely trapped in the upper parts of the airways. Impact is helped by rapid breathing.
 

Particles too large

Sedimentation

Average sized particles [dia between 1 µm and 5µm]

The average sized particles fall under the effect of their own weight into the trachea-bronchial area, an area where the gaseous flow speed is almost zero, notably at the time of the respiratory pause between inhaling and exhaling. This is the method to follow in treatment for broncho-pulmonary ailments.

Particles of the right size for good absorption of the treatment

Diffusion

Small particles [dia ≤ 1µm]

The small particles move in a disordered way colliding with the gas molecules. This is the Brownian movement. They remain in the area of the terminal bronchioles and the cells but this method is of no significance as 80% of these particles remain in suspension in the air and are rejected on exhalation.
 

Particles too small

Nebulisation speed

Nebulisation speed of a generator is variable according to the aerosol used.
It is equal to the volume substance to be nebulised divided by the aerosol's output speed. The time required for the nebulisation of 4ml of medicinal solution may vary between 5 minutes and more than 30 minutes according to the model used !

 

High output

=

Shorter session

=

More effective treatment

Interface choise

 

MASK

 

Indications
Treatment of the «upper» respiratory pathologies (pharyngitis, laryngitis).


Advantages
Multi-purpose and suitable for children.


Disadvantages
Less effective for ENT treatments or lungs than a dedicated nasal or oral mask.

 
MOUTH PIECE

 

Indications
Treatment of the lower respiratory pathologies, asthma, cystic fibrosis, pneumocystosis).


Advantages
This is the most efficient piece for the treatment of the lungs area.


Disadvantages
Not really suitable for children < 5 years of age for ENT treatment.

 

NASAL PIECE

 

Indications
Treatment of ENT diseases (rhinitis, sinusitis, otitis).


Advantages
This is the most efficient piece for the treatment of the ENT area.


Disadvantages
Not really suitable for children < 5 years of age for treatment aimed at the lungs.

Residual or dead volume

At the end of the session when the unit produces no more aerosol some solution remains in the tubing, the walls and the base of the nebuliser. This medication, trapped in the unit and not inhaled, is known as dead or residual volume.

The dead volume is a constant property to each unit shown in the notice. It can vary in accordance with the model used between 0.6 ml and 2 ml.

It is accepted that in order to obtain a satisfactory percentage of inhaled medication, the initial volume to be nebulised must be equal to at least 4 times the dead volume. The dilution of the medication will therefore take into account the dead volume of the unit used.

A nebulizer providing a lower dead volume will require a lower dilution and will allow to reduce session time.

A good dilution is a compromise.

Operating noise

Often forgotten, this is quite a significant matter in carrying out treatment. Particularly with children and chronic patients a session of several minutes will be more easily tolerated and therefore more effective if the equipment does not make too much noise.