Nebulizers in pediatric age: domiciliary use in São Miguel

Authors

DOI:

https://doi.org/10.32385/rpmgf.v38i4.13167

Keywords:

Nebulizers and vaporizers, Domicile, Pediatrics

Abstract

Introduction: Respiratory diseases are a major cause of morbidity in the pediatric population. Nebulizers, for years the most suitable devices for administering aerosol therapy in children, have been superseded by simple inhalation devices. Current clinical guidelines restrict the prescription and use of nebulizers. The study aims to investigate the reality of domiciliary use of nebulizing systems in the pediatric age in the São Miguel Island Health Unit.

Methods: Observational, analytical, and cross-sectional study. Inclusion criteria: children from zero to seven years and 365 days of age. A face-to-face survey was performed on caregivers of the target population to assess the context of the acquisition, use, and maintenance of nebulizers. A significant sample of 380 users was calculated (95% confidence interval).

Results: Participation of 387 caregivers. The average age of children included 2.5 years. 45,7% of participants had a nebulizer and 18,9% reported having a simple inhaler device. The rate of acquisition and use of nebulizers without medical prescription was 67.8% and 79.7%, respectively. The cost of acquiring the nebulization system was between 80 and 150 euros for 38.4% of the participants. Most of the unsupervised use occurred with saline and in the context of nasal obstruction (41.1%) and cough (24.9%).

Discussion: The present study reveals an excessive, unsupervised and inappropriate use of nebulizers in pediatric age. The present investigation should encourage the promotion of the use of simple inhaler devices, by educating users, caregivers, and health professionals, aiming to improve local health practice.

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References

Forum of International Respiratory Societies. The global impact of respiratory disease [Internet]. 2nd ed. Sheffield: European Respiratory Society; 2017. Available from: https://static.physoc.org/app/uploads/2019/04/22192917/The_Global_Impact_of_Respiratory_Disease.pdf

Zar HJ, Ferkol TW. The global burden of respiratory disease: impact on child health. Pediatr Pulmonol. 2014;49(5):430-4.

Borghardt JM, Kloft C, Sharma A. Inhaled therapy in respiratory disease: the complex interplay of pulmonary kinetic processes. Can Respir J. 2018;2018:2732017.

Direção-Geral da Saúde. Cuidados respiratórios domiciliários: prescrição de aerossolterapia por sistemas de nebulização: norma nº 021/2011, de 28/09/2011, atualizada em 11/09/2015. Lisboa: DGS; 2015.

Boe J, Dennis JH, O'Driscoll BR, Bauer TT, Carone M, Dautzenberg B, et al. European Respiratory Society guidelines on the use of nebulizers. Eur Respir J. 2001;18(1):228-42.

Direção-Geral da Saúde. Utilização de dispositivos simples em aerossolterapia: orientação nº 010/2013, de 02/08/2013, atualizada em 18/12/2013. Lisboa: DGS; 2013.

Direção-Geral da Saúde. COVID-19 – Fase de mitigação: cuidados de reabilitação e respiratórios domiciliários: orientação nº 020/2020, de 03/04/2020. Lisboa: DGS; 2020.

Boyter AC, Carter R. How do patients use their nebuliser in the community? Respir Med. 2005;99(11):1413-7.

Butz AM, Eggleston P, Huss K, Kolodner K, Rand C. Nebuliser use in inner-city children with asthma: morbidity, medication use, and asthma management practices. Arch Pediatr Adolesc Med. 2000;154(10):984-90.

Oliveira G, Neto T, Dias C, Oliveira C, Aguiar AP, Rodrigues C, et al. Uso e abuso dos nebulizadores no domicílio [Use and abuse of home-use nebulizers]. Acta Pediatr Port. 2005;36(6):290-6. Portuguese

Direção-Geral da Saúde. Diagnóstico e tratamento da bronquiolite aguda em idade pediátrica: norma nº 016/2012, de 19/12/2012, atualizada em 23/02/2015. Lisboa: DGS; 2015.

Cohen HA, Kahan E, Cohen Z, Sarrel M, Beni S, Grosman Z, et al. Microbial colonization of nebulizers used by asthmatic children. Pediatr Int. 2006;48(5):454-8.

Jarvis S, Ind PW, Thomas C, Goonesekera S, Haffenden R, Abdolrasouli A, et al. Microbial contamination of domiciliary nebulisers and clinical implications in chronic obstructive pulmonary disease. BMJ Open Respir Res. 2014;1(1):e000018.

Published

2022-09-13

How to Cite

Nebulizers in pediatric age: domiciliary use in São Miguel. (2022). Portuguese Journal of Family Medicine and General Practice, 38(4), 357-69. https://doi.org/10.32385/rpmgf.v38i4.13167