Nebulisers for COPD create a fine mist that can be inhaled via a mouthpiece or a mask, by breathing naturally. When doing so, the fine mist reaches the lungs, and the medication or saline solution can have its intended effect. This effect depends on the treatment goal.

Bronchodilators are nebulised to widen the obstructive airways. Isotonic saline solutions moisten the airways. This supports our first line of defense of the lungs against infections. Hypertonic saline can be inhaled to help loosen the thick mucus and thus ease breathing. Mucus clearance is an important treatment goal in COPD.

The use of a nebuliser for the treatment of COPD presents several benefits. Primarily, nebulisers convert liquid medication into a fine mist, enabling deeper penetration into the lungs. This allows for the medication to act directly at the site of inflammation and constriction, offering rapid symptom relief.

Additionally, nebulisers are beneficial for patients who may have difficulty using handheld inhalers due to severe respiratory distress or coordination challenges. The ease of use encourages patients to stick to their treatment routine and therefore treatment outcomes benefit. Nebulisers also allow for a combination of medications to be administered at the same time, which can simplify complex medication plans.

Pros of Nebulisers for COPD

1. Nebulisers can deliver larger doses of medication over a longer period, which may be beneficial for severe COPD exacerbations.
2. They are easier to use for patients with severe COPD who may have difficulty coordinating inhalation with an inhaler ¹.
3. Nebulisers do not require the manual dexterity needed to operate inhalers, making them suitable for patients with physical limitations, for example those suffering from chronic arthritis.
4. They provide an alternative for patients who are not comfortable using inhalers.
5. Nebulisers can be used with a variety of medications, to manage COPD symptoms effectively.
6. Mucus clearance by inhaling saline solutions is only possible with a nebuliser. 

Cons of Nebulisers for COPD

1. Nebulisers are generally bulkier and less portable than inhalers.
2. The treatment time is typically longer with a nebuliser.
3. The use of a nebuliser may be less discrete than an inhaler.

Pros of Inhalers for COPD

1. Inhalers are compact and portable.
2. If used correctly, they provide quick delivery of medication.
3. Inhalers offer a more discreet option for medication administered in a public setting.

Cons of Inhalers for COPD

1. Metered Dose Inhalers (sprays) require coordination between activation and inhalation, which can be challenging for some patients.
2. Some patients may find it difficult to breathe forcefully enough from a dry powder inhaler to get the full dose of medication ².
3. Incorrect use of inhalers can lead to less medication reaching the lungs, therefore reducing their effectiveness.
4. Patients with severe COPD flare ups may not find inhalers as effective as nebulisers for delivering medication.

What is most important when comparing nebuliser vs inhaler for COPD is the patient. Inhaler mishandling is very common amongst patients with severe COPD flare ups ³. GOLD 2024 recommends considering nebulisers if other inhalers have not worked with a patient ⁴. A study also showed that patients and their caregivers preferred nebulisers over other devices due to ease of use, better overall symptom control and long-term relief ⁵.

Efficiency

In cases where nebuliser therapy is advisable, the NICE Guidelines (2019) for the diagnosis and treatment of COPD recommend using a nebuliser that is known to be efficient. Efficiency can objectively be measured by the RDDR (Respirable Drug Delivery Rate). A publication points out that there are major differences between nebuliser systems in terms of efficiency [6]. PARI nebulisers show outstanding performance in terms of RDDR.

High Quality

Select a nebuliser from a trustworthy manufacturer that ensures strict quality standards for your health. There are differences in performance which may reflect the product's price. Therefore, going for the cheapest option might not be the best choice.

• High quality: PARI nebulisers are manufactured in Germany at our own facility with 100% quality control.
• Gold standard: PARI nebulisers are often recommended in the package inserts of medications.
• Highly efficient: Nebulisers by PARI deliver a high amount of active agent to the lungs in a short time.
• As supplied to the NHS.