What are mesh nebulizers?

This is the Flyp Mesh Nebulizer

We are all familiar with pneumatic jet nebulizers. These are the small volume nebulizers (SVNs) we RTs have been using in hospitals for years. Many asthmatics and COPDers use them in the home setting. They are simple to use. They are inexpensive. And it's quite possible they may soon be phased out. Replacing them will be Mesh Nebulizers. So, what are mesh nebulizers? Here's all you need to know.

What are vibrating mesh nebulizers? 

The first mesh nebulizer entered the market in 1993. Like many others, I failed to notice. In fact, I never even heard of mesh nebulizers until 2018. I was having lunch with my fellow RT coworkers. Joining us was a seasoned pharmacist who was new to our facility. He said, "Have you guys heard of the Aerogen. Where I worked before we decided to try them. Our respiratory therapists fell in love with them."

He discussed the Aerogen in detail. He said it's whisper quiet and easy to use. In fact, all you do is squirt in the medicine and push a button. Then you just leave the room. It shuts off itself. And, as we old people do so often, we shunned off the idea. What do we need that for? What we have already works just fine.

Lo and behold, the company I work for purchased Aerogens. Just like that pharmacist said, they are nice. We quickly fell in love with them.

What other mesh nebulizers are available? 

The Aerogen

Aerogens are marketed only for hospitals. Other brands marketed their products for patients. Some products include: Respironics Innospire,  Flyp, Omron Portable MicroAir Nebulizer, and Aura Portaneb.

These nebulizers are mesh nebulizers. They have microscopic disks. These disks have a piezo element. It vibrates at ultrasonic frequencies. This creates turns the medicine solution into a mist.

Particle sizes are similar to those produced by jet nebulizers.

They are small, hand-held devices.

Like inhalers, you can keep them in your pocket or purse.

Unlike jet nebulizers, they are relatively silent.

Jet nebulizer treatments take 10-20 minutes. Mesh nebulizer treatments are only 7 minutes. Some mesh nebulizers are even faster.

And, did I say, they are easily portable.

They don't require a power source (although they do need to be charged occasionally).

Oh, and no tubing.

So why do we still use jet nebulizers? 

In the hospital setting: cost. The aerogen pro x controller costs $1300. The individual nebulizers cost $40 each. Compare that with $2.00 for a jet nebulizer.

In the home setting: mesh nebulizers might be more affordable. Why do I say this? Inhalers cost a lot of money. For me, my Symbicort has a copay of $50 per month. Multiply that by twelve and you get $600 per year.

Now, buy a Mesh nebulizer for $200. Or, buy a DeVilbiss portable nebulizer for $100. Both are nice products. But, if you use your nebulizser a lot, that extra $100 is worth it. Plus, you don't have to buy albuterol inhalers, which cost anywhere from $16-50 copay.

Surely, as they gain in popularity, prices will come down. And when this happens, the mesh nebulizer market may wipe away the jet nebulizer market.

What to make of this? 

Researchers are already in love with mesh nebulizers. They are considering only using them for future clinical trials. So, mesh nebulizers certainly do seem like the wave of the future. What do you think?

References.

1. Gardenhire, Douglas S. et al., “A Guide To Aerosol Delivery Devices for Respiratory Therapists,” 4th Edition, https://www.aarc.org/wp-content/uploads/2015/04/aerosol_guide_rt.pdf, accessed 7/19/19
2. Kacmarek, Robert M, James K. Stoller, Albert J. Heuer, “Egan, Fundamentals of Respiratory Care,” 10th Edition, 2013, Elsevier, pages 836-837
3. Pritchard, et al., “Mesh nebulizers have become the first choice for new nebulized pharmaceutical drug developments,” 2018, January 12, https://www.future-science.com/doi/full/10.4155/tde-2017-0102, accessed 7/19/19
4. Hatley, R.H.M., L.D.H. Hardaker, S. Byrne, "Ultrasonic and Mesh Nebulizers Are Not the Same – Delivery of a Budesonide Suspension," The Aerosol Society, https://aerosol-soc.com/abstracts/ultrasonic-mesh-nebulizers-not-delivery-budesonide-suspension/, accessed 7/30/19