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中华妇幼临床医学杂志(电子版) ›› 2023, Vol. 19 ›› Issue (06) : 636 -642. doi: 10.3877/cma.j.issn.1673-5250.2023.06.003

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雾化吸入治疗中一种新兴雾化装置选择：振动筛网雾化器
胡贵容1, 王伟2, 蔡强2, 谢亮3, 刘瀚旻3,†()   
  1. 1. 四川大学华西第二医院小儿呼吸免疫科、出生缺陷与相关妇儿疾病教育部重点实验室，国家卫生健康委员会时间生物学重点实验室（四川大学），四川大学华西第二医院/复旦大学生命科学学院肺发育与相关疾病联合实验室，成都　610041；宜宾市第二人民医院儿科，宜宾　644000
    2. 宜宾市第二人民医院儿科，宜宾　644000
    3. 四川大学华西第二医院小儿呼吸免疫科、出生缺陷与相关妇儿疾病教育部重点实验室，国家卫生健康委员会时间生物学重点实验室（四川大学），四川大学华西第二医院/复旦大学生命科学学院肺发育与相关疾病联合实验室，成都　610041
  • 收稿日期:2023-06-22 修回日期:2023-11-12 出版日期:2023-12-01
  • 通信作者: 刘瀚旻

A new choice of nebulizers in aerosol inhalation therapy: vibrating mesh nebulizer

Guirong Hu1, Wei Wang2, Qiang Cai2, Liang Xie3, Hanmin Liu3,†()   

  1. 1. Department of Pediatric Respiratory Immunology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, NHC Key Laboratory of Chronobiology (Sichuan University), The Joint Laboratory for Lung Development and Related Diseases of West China Second University Hospital (Sichuan University) and School of Life Sciences of Fudan University, Chengdu 610041, Sichuan Province, China; Department of Pediatrics, the Second People′s Hospital of Yibin, Yibin 644000, Sichuan Province, China
    2. Department of Pediatrics, the Second People′s Hospital of Yibin, Yibin 644000, Sichuan Province, China
    3. Department of Pediatric Respiratory Immunology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, NHC Key Laboratory of Chronobiology (Sichuan University), The Joint Laboratory for Lung Development and Related Diseases of West China Second University Hospital (Sichuan University) and School of Life Sciences of Fudan University, Chengdu 610041, Sichuan Province, China
  • Received:2023-06-22 Revised:2023-11-12 Published:2023-12-01
  • Corresponding author: Hanmin Liu
  • Supported by:
    National Natural Science Foundation of China Regional Innovation Development Joint Fund Project(U21A20333); Key Research and Development Project of Sichuan Science and Technology Department(2019YFS0037); Major Science and Technology Application Demonstration Project of Chengdu Science and Technology Bureau(2019-YF09-00087-SN)
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胡贵容, 王伟, 蔡强, 谢亮, 刘瀚旻. 雾化吸入治疗中一种新兴雾化装置选择：振动筛网雾化器[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(06): 636-642.

Guirong Hu, Wei Wang, Qiang Cai, Liang Xie, Hanmin Liu. A new choice of nebulizers in aerosol inhalation therapy: vibrating mesh nebulizer[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(06): 636-642.

雾化吸入疗法(aerosol inhalation therapy)是利用高速氧气气流或专门的雾化装置(雾化器)，使药液形成雾状，再由呼吸道吸入，达到治疗呼吸道感染疾病，消除炎症和呼吸道水肿，以及解痉、稀化痰液、帮助祛痰的作用，其在人类呼吸系统疾病管理中起着越来越重要的作用。对呼吸系统疾病患儿雾化吸入治疗中，雾化器类型选择，对其临床疗效至关重要。目前临床常用于治疗呼吸系统疾病患儿的雾化器类型包括超声雾化器(UN)、压力射流雾化器(JN)与振动筛网雾化器(VMN)3种。基于不同工作原理的雾化器中，VMN的优势最为明显。笔者拟就雾化吸入疗法的优势和劣势，UN及JN的优、缺点与适用范围，VMN的优势及其应用等的最新研究进展进行阐述，旨在为临床对呼吸系统疾病患儿治疗选用更合适的雾化器提供参考。

关键词: 雾化器和汽化器, 呼吸系统疾病, 雾化吸入疗法, 气溶胶, 超声雾化器, 压力射流雾化器, 振动筛网雾化器, 雾化, 儿童

Aerosol inhalation therapy utilizes high-speed oxygen airflow or nebulizers to transform liquid medicine into a mist, which is then inhaled through the respiratory tract to treat respiratory infections, eliminate inflammation and respiratory edema, and achieve spasm relief, sputum dilution, and help with sputum expulsion. It plays an increasingly important role in management of human respiratory system diseases. The selection of nebulizer type is crucial for clinical efficacy of aerosol therapy in children with respiratory system diseases. Currently, the nebulizers commonly used in clinical treatment for children with respiratory system diseases include ultrasonic nebulizer (UN), jet nebulizer (JN), and vibrating mesh nebulizer (VMN). Among atomizers based on different working principles, VMN has the most obvious advantages. The author intends to elaborate on the advantages and disadvantages of aerosol inhalation therapy, the advantages, disadvantages, and scope of application of UN and JN, as well as the advantages and applications of VMN, in order to provide reference for clinical selection of more suitable nebulizers for treatment of children with respiratory system diseases.

Key words: Nebulizers and vaporizers, Respiratory system diseases, Nebulization inhalation therapy, Aerosol, Ultrasonic nebulizers, Jet nebulizers, Vibrating mesh nebulizers, Nebulization, Child
[1]
Finamore P, Scarlata S, Incalzi RA. Breath analysis in respiratory diseases: state-of-the-art and future perspectives[J]. Expert Rev Mol Diagn, 2019, 19(1): 47-61. DOI: 10.1080/14737159.2019.1559052.
[2]
Mccarthy SD, González HE, Higgins BD. Future trends in nebulized therapies for pulmonary disease[J]. J Pers Med, 2020, 10(2): 37. DOI: 10.3390/jpm10020037.
[3]
中华医学会呼吸病学分会《雾化吸入疗法在呼吸疾病中的应用专家共识》制定专家组. 雾化吸入疗法在呼吸疾病中的应用专家共识 [J]. 中华医学杂志，2016, 96(34) : 2696-2708. DOI: 10.3760/cma.j.issn.0376-2491.2016.34.003.
[4]
刘瀚旻，符州，张晓波，等. 儿童呼吸系统疾病雾化治疗合理应用专家共识[J]. 中华儿科杂志，2022, 60(4): 283-290. DOI: 10.3760/cma.j.cn112140-20220118-00059.
[5]
Valiulin SV, Onischuk AA, Dubtsov SN, et al. Aerosol inhalation delivery of triazavirin in mice: outlooks for advanced therapy against novel viral infections[J]. J Pharm Sci, 2021, 110(3): 1316-1322. DOI: 10.1016/j.xphs.2020.11.016.
[6]
曲海霞，李洁. 利多卡因联合布地奈德雾化吸入对双腔支气管插管患者术后咽喉痛的影响[J]. 中国药物与临床，2020, 20(22): 3777-3779. DOI: 10.11655/zgywylc2020.22.028.
[7]
Macloughlin R, Martin-Loeches I. Not all nebulizers are created equal: considerations in choosing a nebulizer for aerosol delivery during mechanical ventilation[J]. Expert Rev Respir Med, 2023, 17(2): 131-142. DOI: 10.1080/17476348.2023.2183194.
[8]
Park HM, Chang KH, Moon SH, et al. In vitro delivery efficiencies of nebulizers for different breathing patterns[J]. Biomed Eng Online, 2021, 20(1): 59. DOI: 10.1186/s12938-021-00895-3.
[9]
Dobrowolska K, Emeryk A, Janeczek K, et al. Influence of physicochemical properties of budesonide micro-suspensions on their expected lung delivery using a vibrating mesh nebulizer[J]. Pharmaceutics, 2023, 15(3): 752. DOI: 10.3390/pharmaceutics15030752.
[10]
Otto M, Kropp Y, Jäger E, et al. The use of an inspiration-synchronized vibrating mesh nebulizer for prolonged inhalative iloprost administration in mechanically ventilated patients-an in vitro model[J]. Pharmaceutics, 2023, 15(8): 2080. DOI: 10.3390/pharmaceutics15082080.
[11]
Mac Giolla Eain M, Joyce M, Macloughlin R. An in vitro visual study of fugitive aerosols released during aerosol therapy to an invasively ventilated simulated patient[J]. Drug Deliv, 2021, 28(1): 1496-1500. DOI: 10.1080/10717544.2021.1951893.
[12]
Ari A, Fink JB. Quantifying delivered dose with jet and mesh nebulizers during spontaneous breathing, noninvasive ventilation, and mechanical ventilation in a simulated pediatric lung model with exhaled humidity[J]. Pharmaceutics, 2021, 13(8): 1179. DOI: 10.3390/pharmaceutics13081179.
[13]
Hou H, Xu D, Dai B, et al. Position of different nebulizer types for aerosol delivery in an adult model of mechanical ventilation[J]. Front Med (Lausanne), 2022, 9: 950569. DOI: 10.3389/fmed.2022.950569.
[14]
Galindo-Filho VC, Ramos ME, Rattes CS, et al. Radioaerosol pulmonary deposition using mesh and jet nebulizers during noninvasive ventilation in healthy subjects[J]. Respir Care, 2015, 60(9): 1238-1246. DOI: 10.4187/respcare.03667.
[15]
Moody GB, Luckett PM, Shockley CM, et al. Clinical efficacy of vibrating mesh and jet nebulizers with different interfaces in pediatric subjects with asthma[J]. Respir Care, 2020, 65(10): 1451-1463. DOI: 10.4187/respcare.07538.
[16]
Avdeev SN, Nuralieva GS, Soe AK, et al. Comparison of vibrating mesh and jet nebulizers during noninvasive ventilation in acute exacerbation of chronic obstructive pulmonary disease[J]. J Aerosol Med Pulm Drug Deliv, 2021, 34(6): 358-365. DOI: 10.1089/jamp.2020.1665.
[17]
Fink JB, Ehrmann S, Li J, et al. Reducing aerosol-related risk of transmission in the era of COVID-19: an interim guidance endorsed by the international society of aerosols in medicine[J]. J Aerosol Med Pulm Drug Deliv, 2020, 33(6): 300-304. DOI: 10.1089/jamp.2020.1615.
[18]
中华医学会呼吸病学分会呼吸治疗学组. 新型冠状病毒感染重型及危重型患者呼吸治疗相关操作防护措施专家共识[J]. 中华结核和呼吸杂志，2020, 43(4): 288-296. DOI: 10.3760/cma.j.cn112147-20200304-00239.
[19]
Nickerson C, Hollen DV, Garbin S, et al. Pilot study to investigate the benefits of the innospire go mesh nebulizer compared to jet nebulizers in the treatment of stable COPD[J]. J Aerosol Med Pulm Drug Deliv, 2022, 35(4): 186-195. DOI: 10.1089/jamp.2021.0054.
[20]
Chang KH, Moon SH, Yoo SK, et al. Aerosol delivery of dornase alfa generated by jet and mesh nebulizers[J]. Pharmaceutics, 2020, 12(8): 721. DOI: 10.3390/pharmaceutics12080721.
[21]
Beck-Broichsitter M, Gauss J, Gessler T, et al. Pulmonary targeting with biodegradable salbutamol-loaded nanoparticles[J]. J Aerosol Med PulmonDrug Deliv, 2010, 23(1): 47-57. DOI: 10.1089/jamp.2009.0759.
[22]
Zhou JF, Zhang YB, Zhang ZW. Comparison of clinical outcomes following delivery of budesonide by both vibrating mesh nebulizer and jet nebulizer in premature infants with bronchopulmonary dysplasia[J]. Front Pediatr, 2023, 11: 1258846. DOI: 10.3389/fped.2023.1258846.
[23]
Kumar GP, Kulkarni AP, Govil D, et al. Airway management and related procedures in critically ill COVID-19 patients: position statement of the indian society of critical care medicine[J]. Indian J Crit Care Med, 2020, 24(8): 630-642. DOI: 10.5005/jp-journals-10071-23471.
[24]
Lai SK, Mcsweeney MD, Pickles RJ. Learning from past failures: challenges with monoclonal antibody therapies for COVID-19[J]. J Control Release, 2021, 329: 87-95. DOI: 10.1016/j.jconrel.2020.11.057.
[25]
Jardine L, Lui K, Liley HG, et al. Trial of aerosolised surfactant for preterm infants with respiratory distress syndrome[J]. Arch Dis Child Fetal Neonatal Ed, 2022, 107(1): 51-55. DOI: 10.1136/archdischild-2021-321645.
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