References

medsovet

Медицинский Совет

Meditsinskiy sovet = Medical Council

2079-701X2658-5790

REMEDIUM GROUP Ltd.

10.21518/2079-701X-2022-16-1-82-87

medsovet-6688

Research Article

БРОНХОПУЛЬМОНОЛОГИЯ, ОТОРИНОЛАРИНГОЛОГИЯ

BRONCHOPULMONOLOGY, OTORHINOLARYNGOLOGY

Место небулайзерной терапии в лечении бронхиальной астмы у детей

Place of nebulizer therapy in the treatment of bronchial asthma in children

https://orcid.org/0000-0002-9670-9211

Потапова

Н. Л.

Potapova

N. L.

к.м.н., заведующая кафедрой поликлинической педиатрии с курсом медицинской реабилитации

672000, Россия, Чита, ул. Горького, д. 39а

Cand. Sci. (Med.), Head of the Department of Outpatient Pediatrics with Medical Rehabilitation Course

39a, Gorkiy St., Chita, 672000, Russia

nataliapotap@yandex.ru

Читинская государственная медицинская академияРоссияChita State Medical AcademyRussian Federation

2022

27022022

018287

2022

Потапова Н.Л.

Potapova N.L.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.med-sovet.pro/jour/article/view/6688

В обзорной статье представлен анализ данных зарубежных и отечественных исследователей, характеризующих эффективность небулайзерной терапии при бронхиальной астме у детей. В работе рассматриваются новые сведения, сравнивающие эффективность устройств доставки аэрозоля. Преимуществом ингаляционной терапии, определяющим ее широкое использование в детском возрасте, является быстрая доставка в дыхательные пути, высокая местная и низкая системная концентрация лекарственного средства в органах-мишенях. Актуальной проблемой в практике терапии хронических бронхолегочных заболеваний остаются трудности в соблюдении правильной техники ингаляции в связи со сложностью синхронизации вдоха и подачи лекарства, особенно у детей раннего возраста, что приводит к значительному снижению доставленной пациенту дозы медикамента и отрицательно влияет на эффективность лечения. Это, в свою очередь, способствует более тяжелому и неконтролируемому течению, инвалидности и неблагоприятным исходам. Основным недостатком ультразвуковых небулайзеров является инактивация суспензий, антибиотиков и других лекарственных средств. Многие широко используемые струйные ингаляционные системы снабжены компрессорами с высоким уровнем шума, а некоторые распылители открытого типа (без клапанов вдоха и выдоха) имеют большой нераспыляемый (остаточный) объем в камере небулайзера и большие потери аэрозоля в окружающую среду. В связи с этим продолжается совершенствование форм доставки с учетом анатомо-физиологических особенностей органов дыхания, возраста пациентов и коморбидных состояний. К характеристикам оптимального ингалятора обычно относят простоту и удобство использования, надежность, возможность эффективной ингаляции благодаря высокой доставленной дозе респирабельных частиц лекарственных препаратов в сочетании с низкими потерями аэрозоля. С данной позиции одним из универсальных средств транспорта аэрозолей являются мембранные или электронно-сетчатые (меш) небулайзеры, обеспечивающие осаждение лекарства в периферических отделах респираторного тракта во всех возрастных группах детей. Быстрое достижение клинического эффекта, компактность, мобильность расширяют возможности применения меш-небулайзеров на всех уровнях оказания медицинской помощи.

The review article presents an analysis of the data of foreign and domestic researchers characterizing the effectiveness of nebulizer therapy for bronchial asthma in children. The paper considers new data comparing the effectiveness of aerosol delivery devices. The advantage of inhalation therapy, which determines its widespread use in childhood, is its rapid delivery to the respiratory tract, high local and low systemic concentrations of the drug in target organs. Difficulties in observing the correct inhalation technique due to the difficulty of synchronizing inhalation and drug delivery, especially in young children, remain an urgent problem in the practice of treating chronic bronchopulmonary diseases, which leads to a severe and uncontrolled course, disability and adverse outcomes. The main disadvantage of ultrasonic nebulizers is the inactivation of suspensions, antibiotics and other drugs. Widely used jet nebulizers create noise during inhalation, have a large residual volume in the nebulizer chamber. In this regard, the improvement of delivery forms continues, taking into account the anatomical and physiological characteristics of the respiratory organs, the age of patients and comorbid conditions. The characteristics of the optimal inhaler include simplicity and ease of use, reliability, the possibility of effective inhalation of various drugs in combination with economical consumption. From this point of view, one of the universal means of transporting aerosols is membrane or electronic mesh (mesh) nebulizers, which provide excellent regional drug deposition in all age groups of children. The rapid achievement of clinical effect, compactness, mobility expand the possibilities of using mesh nebulizers at all levels of medical care.

бронхиальная астмааэрозольная терапияэлектронно-сетчатые небулайзерытехника ингаляциипотери аэрозоля

asthmaaerosol therapymesh nebulizersinhalation techniqueaerosol loss

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The authors declare that there are no conflicts of interest present.