bmjourБайкальский медицинский журналBaikal Medical Journal2949-0715Irkutsk State Medical University10.57256/2949-0715-2023-1-50-59bmjour-30Research ArticleЛекции для студентов, ординаторов и аспирантовLectures for students, residents and postgraduatesСОВРЕМЕННЫЕ АСПЕКТЫ НЕБУЛАЙЗЕРНОЙ ТЕРАПИИMODERN ASPECTS OF NEBULIZER THERAPYhttps://orcid.org/0000-0002-2603-0051БуйноваСветлана НиколаевнаBuynovaSvetlana N.

Доцент кафедры клинической аллергологии и пульмонологии ГБОУ ДПО ИГМАПО, к.м.н.

Cand.Med.Sci., associated professor Department of Clinical Allergology and Pulmonology, Irkutsk State Medical Academy of Postgraduate Education – Branch of Russian Medical Academy of Continuing Professional Education

33s1@rambler.ruГБОУ ДПО ИГМАПОРоссия202310032023215059Copyright © Буйнова С.Н., 20232023Буйнова С.Н.Buynova S.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bmjour.ru/jour/article/view/30

Небулайзерная терапия широко используется в современной респираторной медицине. К небулайзерам  относят  устройства, преобразующие жидкость в аэрозоль, пригодный для вдыхания пациента, и соответствующие требованиям европейского стандарта небулайзерной терапии prEN 13544-1. Принципиальными отличиями небулайзеров от других ингаляционных устройств (дозирующих аэрозольных ингаляторов, порошковых ингаляторов) являются возможность проведения маневра на спонтанном дыхании, использование лекарственных препаратов, для которых нет других средств доставки, а также возможность подбора  дозы препарата в зависимости от потребностей пациента.

Хотя этот способ доставки эффективен при многих заболеваниях органов дыхания и является предпочтительным у особых групп пациентов (детей, пожилых, а также при тяжелых обострениях и др.), имеются некоторые особенности и ограничения его использования, что необходимо учитывать клиницистам. По принципу действия небулайзеры делят на компрессорные, ультразвуковые и электронно-сетчатые, отличающиеся техническими характеристиками и показаниями к применению.  Компрессорные небулайзеры наиболее широко применяются как  в медицинских учреждениях (отделениях интенсивной терапии, стационарах, кабинетах), так и  в домашних условиях, относительно недороги, просты и удобны в обслуживании, имеют дополнительные комплектующие принадлежности (камеры с клапанами вдоха-выдоха, маски для детей и взрослых,  назальный аспиратор и др.). Современные струйные небулайзеры оснащены переключателями   режимов распыления, благодаря чему можно регулировать скорость подачи аэрозоля и аэродинамический диаметр частиц средней массы от 2-3 до 10 мкм. В зависимости от выбора режима переключателя и соответствующего лекарственного средства небулайзер можно использовать при лечении ринита, ларингита, бронхита, астмы и других заболеваний как верхних, так и нижних дыхательных путей.

Nebulizer therapy is widely used in modern respiratory medicine. Nebulizers are devices that convert a liquid into a suitable for inhalation by a patient aerosol, which meets the requirements of the European standard for nebulizer therapy prEN 13544-1. The fundamental differences between nebulizers and other inhalation devices (metered aerosol inhalers, powder inhalers) are the possibility to perform maneuvers on spontaneous breathing, the use of drugs, which do not involve the use of other inhalers, and the possibility to select drug doses depending on patients need.

Although this delivery method is effective for many respiratory diseases, and it is preferred for special groups (children, the elderly, as well as severe exacerbations, etc.), there are some peculiarities and limitations of its use, which should be taken into account by clinicians. According to the principle of operation, nebulizers are divided into compressor, ultrasonic and electronic-mesh, which differ in technical characteristics and indications for use. Compressor nebulizers are most widely used in medical institutions (intensive care units, hospitals, offices) and at home, relatively inexpensive, simple and easy to maintain, have additional components (chambers with inhalation-exhalation valves, masks for children and children) adults, nasal aspirator, etc.). Modern jet nebulizers are equipped with spray mode switches, so that the aerosol feed rate and the aerodynamic diameter of particles of an average mass from 2-3 to 10 microns can be adjusted. Depending on the selection of the switch mode and the corresponding medication, the nebulizer can be used in the treatment of rhinitis, laryngitis, bronchitis, asthma and other diseases of both upper and lower respiratory tract.

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The authors declare that there are no conflicts of interest present.