Lapis ISSN 2398-2969

Respiratory: nebulization

Synonym(s): Aerosol therapy

Contributor(s): David Perpinan, Vladimir Jekl

Introduction

  • Nebulization is a method of topical treatment for both the upper and the lower respiratory tract.
  • It involves using compressed air through a machine (nebulizer) to convert liquid medication into a mist that can be breathed in by the patient.
  • A wide range of drugs may be nebulized, including antibiotics, mucolytics, bronchodilators, etc.

Uses

  • It can be used for the adjunctive treatment of respiratory problems, particularly bacterial pneumonia, but also for rhinitis, sinusitis, fungal pneumonia, allergic respiratory disease, and tracheitis, eg following endotracheal intubation Endotracheal intubation.

Advantages

  • The risk of systemic side effects is lower than with oral or parenteral medication, and therefore antibiotics that are considered dangerous to rabbits when used orally or parenterally can be used through nebulization.
  • Even nebulization with saline alone may be useful to rehydrate the natural mucociliary   escalator and enable the rabbit’s natural defenses to remove bacteria from the lungs. Isotonic saline should be used.
  • If the compound of interest is not very soluble in water, propylene glycol can be added to aid solubility.

Disadvantages

  • Nebulization needs to be combined with other treatments to try to achieve a cure for conditions such as rhinitis and pneumonia.
  • The nebulizer needs to produce particles 1-5 µm in order to penetrate into the narrow branches of the lower airways. The larger the particles, the sooner they drop out of suspension in the mist and therefore the less far into the respiratory tract they are able to penetrate.
  • Treating only with nebulized antibiotics rarely achieves proper concentrations in blood and internal tissues, and therefore it predisposes to the development of resistance.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Depend on the type and severity of the condition.

Further Reading

Publications

Refereed papers

Other sources of information

  • Meredith A & Lord B (2014) Eds BSAVA Manual of Rabbit Medicine. BSAVA, UK. pp 328.
  • Varga M (2014) Ed Textbook of Rabbit Medicine. 2nd edn. Butterworth-Heinemann, UK. pp 494.
  • Mayer J & Donnelly T M (2013) Clinical Veterinary Advisor: Birds and Exotic Pets. Elsevier, USA. pp 752.


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