Nebulizers and Asthma: Which Nebulizer is Right For Me?

What You Need To Know About Nebulizers And Your Asthma

Nebulizers, or "breathing machines," as they are often referred to by patients, are devices that allow you to aerosolize liquid asthma medication and inhale it directly into your lungs as a mist. Along with metered dose inhalers (MDIs) and dry powdered inhalers (DPIs), nebulizers are just one of the devices used to deliver your inhaled asthma medication.

Types of nebulizers used for asthma medicine include:

  • Jet Nebulizers
  • Ultrasonic Nebulizers
  • Mesh Nebulizers

Many different factors -- including cost, your preferences, and your doctor's preferences -- will determine which nebulizer is best. The kind of asthma medication prescribed also determines which nebulizer can be used. The nebulizers are free-standing but also come in portable models.

Advantages Of Nebulizers

The need for minimal patient cooperation is one of the biggest benefits of using a nebulizer. As a result, nebulizers are often used for infants and young children in the hospital or emergency department. Not only are nebulizers significantly easier to use than MDIs, they're also advantageous if your coordination is not sufficient to appropriately use an MDI. MDIs require a level of skill to correctly deliver medicine to your lungs that can be difficult for patients. When used incorrectly, MDIs may deposit most of the medication into the back of your mouth instead of into your lungs, and can lead to side effects like hoarseness and thrush.

Nebulizers are easy to use. Through your normal breathing, they allow for the correct dose of medication to get where it is needed most: deep into your lungs.

How Do Different Nebulizers Work?

While different nebulizers will have certain properties that may make one nebulizer more appropriate or desirable, no specific nebulizer is better than another for your asthma.

  • Jet nebulizers deliver a fine liquid mist of medication through a mouthpiece using compressed air. Jet nebulizers have a small plastic cup with an attached mouthpiece where the liquid medicine is placed. The mouthpiece is connected by plastic tubing to the compressed air source and a motor. As air passes through the small plastic cup containing the liquid medication, the liquid medication is converted to a fine mist which can then be breathed into the lungs. Jet nebulizers are the most commonly prescribed because they are easy to use and inexpensive. Traditional jet nebulizers are often bulky and require an electrical source, which can be a problem when you are traveling. Your asthma treatments also take longer with jet nebulizers, because medication must be mixed with saline. Finally, jet nebulizers are a lot noisier than other types of nebulizers.
  • Ultrasonic nebulizers use a transducer to produce ultrasonic waves that aerosolize your asthma medication. Like jet nebulizers, ultrasonic nebulizers require little patient coordination, but can deliver breathing treatments significantly faster than jet nebulizers and do not require mixing saline with your asthma medication. Ultrasonic nebulizers do not require a compressor and are much more compact. Additionally, ultrasonic nebulizers are quieter and come in portable, battery operated units.
  • Mesh nebulizers vibrate a small mesh membrane at very high speeds and as liquid medication is forced through tiny holes in the mesh, an aerosol is produced. Mesh nebulizers are the fastest and also most expensive of the nebulizers. Like ultrasonic nebulizers, battery operated portable models are available, making them very convenient. Because of the vibrating mesh, however, mesh nebulizers need to be cleaned frequently to avoid clogging of the small openings used to create the mist. Finally, a number of experts recommend a backup nebulizer in case the mesh nebulizer fails. This creates added expense.

    You can check out a number of different models and prices of nebulizers from these companies:

    While it's important for you to follow use and cleaning instructions that come with your nebulizer, it will generally include these steps:

    1. Place the appropriate amount of medication in the plastic nebulizer cup.
    2. Assemble the nebulizer as per instructions.
    3. Insert the mouthpiece. If you have a small child your doctor may elect to use a face mask.
    4. Turn on the machine.
    5. Begin breathing normally and continue until all the medication is gone. If you have a small child you will probably want to remain present for the entire treatment.
    6. Turn off the machine.
    7. Clean the machine per instructions.

    Are Nebulizers Effective?

    Despite their ease of use, research has not demonstrated that asthma control is better when your asthma medication is delivered via this device. Some research has shown that less than half of the dose of common inhaled steroids makes it into your lungs when a nebulizer is used. This has obvious implications for your asthma control. You may need more medication to control your symptoms, an increased dose, or need to take more treatment.

    There is also a significant time disadvantage. A nebulizer treatment is usually mixed with water and the treatment takes about 10 minutes. On the other hand, a MDI with a spacer can deliver the same amount of medicine to your lungs in less than a minute. Interestingly many patients still feel that the nebulized treatments are more powerful even though the medication dose is often exactly the same.

    Nebulizers And Young Children

    Nebulizers can be scary for young kids, especially when first diagnosed with asthma. Here are a couple of tips and tricks to make breathing treatments easier:

    • Nebulizers can be fun. Make the nebulized treatments a fun time with your child. Play special games, watch a movie, or read your child a book. Medical supply companies also sell attachments that turn your nebulizer into a fire truck or a bear.
    • Create a routine. For your child's scheduled breathing treatments, the more successful you are in creating a routine, the less resistance you will likely receive from them.

    Caring For Your Nebulizers

    Cleaning your nebulizer is important: not doing so increases your risk of a respiratory infection like pneumonia. In general, all you need to do is wash your nebulizer pieces with warm, soapy water after each treatment and let them air dry on paper towels. Check your user manual to see if the pieces can be washed in the dishwater.


    American Academy of Allergy Asthma & Immunology. Accessed June 1, 2016. Tips to remember: Inhaled Asthma Medications.

    NHLBI Guidelines for the Diagnosis and Treatment of Asthma. Accessed June 1, 2016. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma.

    Tashkin DP. Accessed June 1, 2016. The Role Of Nebulizers In Airways Disease Management

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