The Three Types of Nebulizers

There are many respiratory medicines currently on the market. A common way of inhaling these is by using inhalers. Another common way is by using nebulizers. Here is a look at the different types of nebulizers currently available on the market.

Types of nebulizers and their differences

These are small, hand-held devices that deliver aerosolized medications. They are generally referred to as nebulizers. At present, there are three types of SVNs: Pneumatic Jet Nebulizers, Ultrasonic Nebulizers, and Mesh Nebulizers

Pneumatic Jet Nebulizers

These are the we are most familiar with. They are operated using compressed air. In the hospital they can be hooked up to oxygen or air flowmeters. In the doctor’s office or home setting they are hooked up to air compressors. Nebulizer plus air compressors can usually be purchased together. They are called nebulizer systems. Nebulizers can also be purchased independently.

• How they work? They are called jet nebulizers because air flows rapidly through a jet. This creates a rapid stream through the medicine solution sitting in the nebulizer cup. A negative pressure is created alongside this stream, and medicine is sucked into the stream. This is what creates the mist.
• Advantages? They are commonly used at home, doctor’s offices, and hospitals. They are relatively inexpensive. You can buy many nebulizer systems online for under $50. The nebulizers generally cost less than $5 each. In fact, the Micro Mist Nebulizer is only $1.05. Newer nebulizer systems are portable and can be plugged into any car’s charging port are/or are battery operated.
• Disadvantages. The down-side is they require a flow source, which is usually supplied by an air compressor. These compressors require an electricity source. Treatment times vary from 5-20 minutes. The convennience of portable nebulizer systems tend to make them more expensive. For example, the Devilbiss Portable Nebulizer costs $100. Some specialized nebulizers may cost as much as $15-30. An example here is the breath enhanced nebulizer.
• Examples? Jet nebulizers and nebulizer systems (nebulizer plus air compressor) have been FDA approved for many years. Common nebulizer systems include Devilbiss Pulmo-Aide Nebulizer, Devilbiss Portable Nebulizer, Pari-Vios Nebulizer System, Innospire Mini Compressor Nebulizer, and Omron Compair Nebulizer System. There are also many generic jet nebulizer systems on the market that are quite affordable. Examples of nebulizers include micro mist nebulizer and sidestream nebulizer.

Ultrasonic Nebulizers

These have been around since the 1970s. Initially they were used in hospitals to deliver hypertonic solution to patients. By the time I became an RT 22 years ago they were no longer used. Today there are a few on the market available for the general population. These are often marketed as “cool mist devices.”

• How they work? They utilize electricity. A crystal transducer sits at the bottom of the nebulizer cup. This transducer creates high frequency vibrations to the surface of the water. This creates a wave that creates a mist
• Advantages. These are nice devices for delivering aerosols. They tend to be much quieter than jet nebulizers. There are tabletop and portable units available. The nebulizers themselves cost less that $5 to replace, so they are quite affordable. (1)
• Disadvantages. Historically, they tend to cost more than jet nebulizers. Although, some are very reasonably priced. For example, the Fox-Starc Nebulizer is $34.95. It’s also portable. Also, they are fine for delivering medicines like albuterol, but are not so good at delivering medicines like budesonide.¹
• Examples? This type of nebulizer has been FDA approved for many years, and is also easy to enter. However, this type is not as well accepted as jet nebulizers. Still, there are some on the market, including the Unicliff Portable Compressor and T-Star Compressor System.

Mesh Nebulizers

These offer a relatively new way of turning respiratory medicine into a fine mist for inhaling. The first one was introduced to the market in 1993. It was called the Omron NE-U03. Today they seem to be quickly gaining in acceptance and popularity. So much so that some researchers are considering only using these nebulizers when performing clinical trials.^2-3.

• How they work? They “use electricity to vibrate a piezo (at approximately ~128 KHz) element that moves liquid formulations through a fine mesh to generate aerosol.” The aerogen is an example of one we use in the hospital setting.²
• Advantages. There are some battery operated ones that are quickly becoming popular among the COPD and asthma communities. These are so small they can be held in your hand. Studies show they are equally effective at delivering respiratory medicines to airways as jet nebulizers in half the time. They are much quieter than jet nebulizers. They waste much less medicine than jet nebulizers do. Plus, as a bonus, they are also easier to use.^2-3
• Disadvantages. Since they are relatively new to the market they tend to cost a lot. Also affecting the cost are all the parts needed to put one together. Just to give a cost example, the Flyp Nebulizer (see below) is selling for $199. Vibrating mesh replacement must be done every 3-12 months. The cost is $40 to $150, depending on the brand.^3-4
• Examples. Flyp Nebulizer, The Respironics Inospire, eFlow Rapid Nebuliser, Aeroneb Go, Velox Mesh Nebulizer,Omron Micro-Air Electronic System and Aura Portable Nebulizer. These are marketed for home use. The Aerogen is marketed for hospital use.

What nebulizer may work best for you?

Jet nebulizers are also the least expensive. So, these are usually what insurance companies, Medicare, and Medicaid will cover. They will also pay for basic tabletop air compressors. If you want something more convenient, there are many options on the market. There are portable jet nebulizers. There are mesh nebulizers almost as small as inhalers. However, you’ll have to pay for the convenience. Is the price worth the convenience? Let us know what you think in the comments below.