A guideline for Dubai parents on whether your child should opt for inhalers or nebulizers when it comes to asthma treatment.
27 July 2020| Last updated on 28 July 2020
Pictured: Pressurized metered-dose inhalers (pMDIs)
Find out which option would suit your child's health needs, based on an expert guide from Mediclinic City Hospital in Dubai.
Asthma is the most common chronic diseases of childhood. Almost 10% of children are on daily or intermittent inhaled asthma medications.
The natural history of asthma is variable and difficult to predict for a particular individual. Children with asthma experience complete remission more frequently than adults; many infants wheeze early in life, but three of four school-aged children outgrow asthma by adulthood. On the other hand, the majority of chronic asthma begins in the first six years of life.
Progression to severe disease is unusual in all age groups. Although deaths do occur from asthma, they are rare, and asthma in the absence of other comorbid disease does not typically affect life expectancy.
The two main goals of managing asthma are achieving good control of asthma-related symptoms and minimizing future risk (asthma exacerbations, suboptimal lung function, and adverse effects of medication). One of the means to achieve these goals is to achieve the right method of delivering the asthma medications.
Inhaler versus nebulizer
Both Nebulizers and inhaler devices are used to deliver asthma medications, but which option is better for your child?
Children lack the coordination required to trigger and simultaneously inhale a drug when using Pressurized metered-dose inhalers (pMDIs), hence the use of adjuncts such as spacers with mouthpieces or face masks overcomes this difficulty.
Pressurized metered-dose inhalers (pMDIs) with spacers is the preferred method for children by most of pediatricians, pulmonologists and widely recommended by most international Asthma guideline for a number of reasons.
1. Dose delivered
When using a nebulizer, less than 10% of the aerosolized drug reaches the lungs, with large deposits remaining in the apparatus or on the face, and the remainder lost to the surroundings.
However with pMDIs inhaler with spacer, 40% of the areolised drug may reach the lungs.
pMDIs inhalers with spacers are better tolerated and portable. Parents can carry it in their bag if needed outside and older children can have it in their school bag if required at school.
Pictured: Spacer with mouthpiece
3. Adverse events
Studies showed less adverse events (e.g. tremor and anxiety) are associated with inhalers versus nebulizers.
4. Infection control
Inhalers with spacers are easy to clean with reduced risk of being contaminated when compared to nebulizers. Recent study have proven that a nebulizer (airborne procedure) could aerosolize droplets containing the COVID19 virus, allowing the virus to stay in the air longer.