Figures & data
Table 1 Features of different nebulizers6
Figure 1. Examples of marketed nebulizers that incorporate newer technologies. The eFlow (PARI, Midlothian, VA), MicroAir (Omron, Vernon Hills, IL,), I - Neb (Phillips Healthcare, Murrysville, PA) and Aeroneb (Aerogen, Galloway, IRE) incorporate VM/VAP aerosol generators. The I-neb and Akita Control System (Activaero,GER) employ Adaptive Aerosol Delivery technology as the patient/device interface for delivering and monitoring aerosol treatments. TheI-Neb and eFlow are formulation-specific for iloprost and cayston, respectively, and as such are not part of current COPD treatment paradigms. The Respimat (Boehringer-Ingelheim, Ingelheim GER) is a high efficiency soft-mist inhaler that employs a precise dosimetric system with multi-dose capability. All of these devices are approved for use in the United States. Photos courtesy of Myrna Dolovich, P.Eng.
![Figure 1. Examples of marketed nebulizers that incorporate newer technologies. The eFlow (PARI, Midlothian, VA), MicroAir (Omron, Vernon Hills, IL,), I - Neb (Phillips Healthcare, Murrysville, PA) and Aeroneb (Aerogen, Galloway, IRE) incorporate VM/VAP aerosol generators. The I-neb and Akita Control System (Activaero,GER) employ Adaptive Aerosol Delivery technology as the patient/device interface for delivering and monitoring aerosol treatments. TheI-Neb and eFlow are formulation-specific for iloprost and cayston, respectively, and as such are not part of current COPD treatment paradigms. The Respimat (Boehringer-Ingelheim, Ingelheim GER) is a high efficiency soft-mist inhaler that employs a precise dosimetric system with multi-dose capability. All of these devices are approved for use in the United States. Photos courtesy of Myrna Dolovich, P.Eng.](/cms/asset/e392b6b6-0fa8-4719-91cd-a0a831c46154/icop_a_630047_f0001_b.jpg)
Table 2 Clinical scenarios where maintenance nebulizer therapy is preferred in patients with COPD*
Figure 2. Pharmacological therapy of COPD by severity classification (stages I – IV). Delivery by nebulizer may be appropriate at any stage according to patient needs and preferences. (Adapted from ATS/ERS41 and GOLD3).
![Figure 2. Pharmacological therapy of COPD by severity classification (stages I – IV). Delivery by nebulizer may be appropriate at any stage according to patient needs and preferences. (Adapted from ATS/ERS41 and GOLD3).](/cms/asset/13e5665e-9f78-48fb-9192-c472924b5008/icop_a_630047_f0002_b.gif)
Table 3 Commonly used nebulized medications for patients with COPD*
Table 4 Studies evaluating use of nebulized drugs for maintenance therapy in COPD.
Table 5 Studies on the use of nebulized budesonide (BUD) vs. prednisolone (PRED) for exacerbations of chronic obstructive pulmonary disease