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Table 1 Comparison of different types of nebulizers

From: Fundamentals of aerosol therapy in critical care

Nebulizer type Mechanism of action Types Advantages Disadvantages
Jet [68] Pressurized gas forms a jet passing through a tube creating a low-pressure zone (Venturi effect) that draws liquid formulation into the jet stream (Bernoulli effect) • With a corrugated tube • Cheap • Inefficient
• With a collection bag • Easy to use • Difficult to clean
Droplet size > 5 μm • Breath-enhanced jet nebulizers • Effective in delivering drugs that cannot be delivered with pMDIs and DPIs • Need compressed gas and additional tubing
• Breath-actuated jet nebulizers • Breath-enhanced and breath-actuated options
Ultrasonic [70, 131] Piezoelectric crystal converts an electrical signal into high-frequency vibrations in the liquid, forming an aerosol using cavitation and capillary mechanisms • Small volume (e.g. for medications) • Easy to use • Large residual volume
• Large volume (e.g. for hypertonic saline used for sputum induction) • More efficient than jet nebulizers • Unable to nebulize viscous solutions
Drug output alpha vibration amplitude • Shorter nebulization time (better for large volumes) • Degradation of heat-sensitive materials—so inappropriate for proteins
Particle size alpha vibration frequency
Droplet size variable, may be less than 5 μm • Aerosol temperature 10–14 °C higher than that in jet nebulizer
• Large device size
Vibrating mesh [19, 70] Aerosol is produced by forcing the liquid using the micropumping action through the vibrating mesh containing funnel-shaped holes • Active (e.g. Aeroneb®; Aerogen, Galway, Ireland) • Silent operation, portable • More expensive
Droplet size < 5 μm
• Passive (e.g. Microair NE-U22®; Omron, Bannockburn, IL, USA) • Short treatment time • Cleaning can be difficult
• Minimal residual volume • Drug dose needs to be adjusted in transition from jet nebulizers
• Self-contained power source • Inability to use to aerosolize viscous liquids
• Optimize particle size for specific drugs • Inability to aerosolize drugs that crystallize on drying
• More output efficiency than other nebulizers
• Two to three times higher drug deposition compared with jet nebulizers
• Aerosol temperature usually unchanged
• Unchanged osmolality
• Easy to use
  1. pMDI pressurized metered dose inhaler, DPI dry powder inhaler