| Type | Advantages | Disadvantages |
| Jet nebulizer* | - Patient coordination not required
- High doses possible
| - May be more expensive than pMDI
- More time required
- Contamination possible
- Device preparation required before treatment
- Not all medications available
- Less efficient than other devices (dead volume loss)
|
Mesh nebulizer
(eg, Aeroneb, eFlow, Omron MicroAir, I-neb) | - Patient coordination not required
- High doses possible
- Quiet
- Faster delivery than jet nebulizer
- Portable, battery operated
| - Expensive
- Contamination possible
- Device preparation required before treatment
- Cleaning required after dose
- Not all medications available
|
Ultrasonic nebulizer
(eg, OPTI-NEB, Beetle Neb, Lumiscope, MiniBreeze) | - Patient coordination not required
- High doses possible
- Small dead volume
- Quiet
- No drug loss during exhalation
- Faster delivery than jet nebulizer
| - Expensive
- Contamination possible
- Prone to malfunction
- Device preparation required before treatment
- Cannot use with medications in suspension (eg, budesonide)
|
| Pressurized metered dose inhaler (pMDI) | - Convenient
- May be less expensive than nebulizer
- Portable
- More efficient than nebulizer
- No drug preparation required
- Difficult to contaminate
| - Patient coordination essential
- Patient actuation required
- High pharyngeal deposition
- Difficult to deliver high doses
- Not all medications available
|
| pMDI with holding chamber | - Less patient coordination required
- Less pharyngeal deposition
| - More expensive than pMDI alone
- Less portable than pMDI alone
|
| Dry powder inhaler (DPI) | - Less patient coordination required
- Convenient
- Propellant not required
- Portable
- Breath-actuated
| - Requires moderate to high inspiratory flow
- Some units are single dose and need daily loading
- Can result in high pharyngeal deposition
- Not all medications available
- Cannot be used effectively in mechanically ventilated patients
|
| Soft mist inhaler (SMI) | - Higher lung deposition than pMDIs or jet nebulizers
- Less pharyngeal deposition than pMDIs
- Longer duration of spray
- Low risk of contamination
- Propellant not required
| - Requires actuation by patient
- Needs coordination between breathing and actuation¶
- Requires loading of cartridge into inhaler before first use
- Not all medications available
- Cannot be used effectively in mechanically ventilated patients
|
