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Types of inhalation therapy. Inhalation therapy: types, purpose, indications and contraindications

Respiratory diseases occur in medical practice extremely often, leading to the development in patients unpleasant symptoms in the form of a runny nose, cough, shortness of breath, etc. In pulmonology, various therapeutic approaches related to the use of medications and physical therapy are used to treat diseases. In addition to the use of medications, the most popular treatment methods are inhalation therapy. This approach makes it possible to have a selective effect on organs respiratory system, increasing the effectiveness and safety of the treatment.

History of the development of the method

The use of inhalations for the treatment of respiratory diseases was noted at the beginning of the last millennium. However, such inhalation procedures were carried out passively and consisted of inhaling vapors of infusions and decoctions of various medicinal herbs. The rapid development of this area of physiotherapy began in the 19th-20th centuries, when a device was first created that made it possible to create an aerosol from a liquid. It was this invention that led to the development of inhalation treatment methods and their widespread introduction into clinical practice.

Inhalations can be primary or additional therapeutic method, which is determined by the patient’s disease, its severity, as well as the presence of concomitant pathologies.

Later, an inhaler was created that allows a dosed volume of liquid to be administered when inhaling. At the end of the 20th century, powder dispensers began to be used in medicine, making it possible to use more wide range medicines.

In addition, for inhalation in childhood Nebulizers are widely used, as well as in adult patients. These devices make it possible to create a fine aerosol of medications that penetrates the patient’s lungs to the smallest bronchi, ensuring high effectiveness of therapy.

Types of devices

For therapeutic purposes in the field of pulmonology it is used large number various devices, allowing the delivery of drugs to the bronchial tree. It is worth highlighting separately: liquid and powder inhalers, steam inhalers, as well as devices operating on ultrasound and compression. Each of them has certain pros and cons that should be taken into account when choosing an inhalation method.

The use of metered dose liquid inhalers has the following advantages:

compactness of the device;
simple design, ensuring reliability and rare technical problems;
high accuracy of drug dosing.

However, when using such devices, there are certain disadvantages:

the importance of synchronizing breathing movements using a balloon;
in case emergency situation, for example, during an attack of suffocation, the patient is not able to use the device correctly;
low efficiency of penetration of aerosol particles deep into the bronchial tree, which is further reduced with swelling of the mucous membranes;
part of the drug is swallowed, which can lead to the development of systemic effects, as well as undesirable drug reactions.

Powder metered dose inhalers have similar pros and cons to their use. However, the patient does not need to synchronize their breathing with the use of the device, since the device is automatically activated during the inhalation process.

The most common inhalers used to treat the respiratory system are compression devices, consisting of a nebulizer (drug nebulizer) and a compression unit that creates an air flow. It is important to note that the depth of penetration of the drug into the respiratory tract depends on the size of its particles.

The choice of the optimal device for inhalation therapy is determined by the attending physician depending on the person’s age, specific disease and the availability of available inhalers.

Nebulizers can be used in a medical facility or at home, after preliminary consultation with a therapist or pulmonologist. Modern devices for inhalation therapy are easy to handle and safe for use outside of hospitals.

Indications and contraindications

The use of inhalation treatments in patients depends on the presence of certain indications and contraindications. The procedures are indicated for those patients who have the following conditions:

diseases of the respiratory system (rhinitis, pharyngitis, tracheitis, bronchitis) of an acute and chronic nature, as well as their complications;
pneumonia of any cause;
bronchial asthma;
bronchiectasis in the lungs;
postoperative therapy aimed at preventing the development of complications;
emergency conditions associated with respiratory dysfunction.

To improve the safety of inhalation therapy, the doctor assesses whether the patient has the following contraindications and, if available, refuses this method treatment:

signs of intrapulmonary bleeding;
presence of pneumothorax;
emphysema with the formation of bullae;
decompensated diseases of the cardiovascular system;
inability to use medications due to individual intolerance or allergic reactions.

Determine indications and contraindications for inhalation therapy when a patient applies for medical care. It is important to note that self-medication is unacceptable, as the patient may develop side effects from the medications or progress the underlying disease.

Benefits of using nebulizers

Compression inhalers, that is, nebulizers, have many advantages over other types of inhalation devices. The main advantages include:

the procedure does not require specific knowledge from the patient and is very simple;
medications are not destroyed during treatment, which ensures their economical and rational use;
more than 75% of drug molecules are delivered to the final sections respiratory tract;
the use of a nebulizer does not require breathing synchronization, which allows inhalation even in childhood;
compression devices can be used in the elderly and in patients with severe diseases of internal organs;
nebulizers allow you to dose medicine;
the devices are approved for use outside of medical institutions, as they do not require special maintenance.

Such advantages determine the prevalence of this type of inhaler, which is installed not only in hospitals and clinics, but also at home.

Carrying out inhalations

Using a nebulizer takes place in two stages: preparation of the device and the actual procedure. Before starting inhalation, a person should prepare the device for use and adhere to the following recommendations:

for treatment use only those medications prescribed by the doctor;
smoking for 3 hours before and after inhalation is prohibited;
The preparation of the nebulizer is carried out according to the instructions for the device;
the required economizer and nozzle are put on the dry sprayer; depending on the method of use, a face mask, mouthpiece or nasal cannula may be used;
the compressor and the sprayer must be tightly connected to each other;
using a disposable syringe in bottom part The prepared medication is poured into the nebulizer; its volume should not be less than 2 ml.

After the device is ready, inhalation therapy is carried out according to the following algorithm:

The patient should sit up straight and relaxed. Hands should be placed on a table or any other horizontal surface.
After preparing the nebulizer for operation, the device is turned on and checked for functionality.
The device should always be held vertically, as otherwise the efficiency of aerosol formation may be reduced.
For inhalation therapy of the lower respiratory tract, a mouthpiece is used. The plug at the top of the mouthpiece should be kept closed.
If a therapeutic effect on the upper respiratory tract is necessary, a face mask or nasal cannula is used, which is tightly attached to the nebulizer. Even if a nasal cannula is selected, inhalation is done through the mouth.
The inhalation should be calm. There is a hole on the economizer that is closed with your finger while inhaling. After this, a short pause is made and the hole opens, allowing you to exhale. The exhalation should be slightly slower than the inhalation.
When using the method in childhood and in patients with severe illnesses, the nebulizer is used with a face mask. IN in this case the patient does not have to worry about his breathing.
When you have finished using the inhaler, you should disassemble it and rinse it thoroughly. For washing use regular soap solution, after which parts of the device should be additionally rinsed plain water. If there is condensation on the internal parts of the device, the device should be disassembled and dried.
The patient is advised to remain indoors for 30-40 minutes after inhalation to reduce the risk rapid removal drugs from the respiratory tract.

Regardless of where it is held inhalation treatment– at home or in a medical facility, the procedure should be performed according to the described algorithm. This allows you to increase its effectiveness and reduce the risks of developing negative consequences.

Drugs used

A large number of drugs are used for inhalation therapy. They belong to different pharmacological groups and have specific mechanisms of action.

Antiviral medications

For diseases viral etiology The most effective antiviral drugs are:

Inhalation of human leukocyte interferon allow you to raise nonspecific immune protection. As a rule, one course of treatment takes 10 procedures, and inhalations are carried out 2-5 times a day, depending on the severity of the disease.
Interferon inducers (Poludan, etc.) are widely used, which enhance antiviral immunity and rapid recovery of the patient.
The use of Aminocaproic acid is justified for influenza infection and parainfluenza virus. The duration of therapy in this case is from 3 to 5 days.

Antiviral drugs are moderately effective and are usually used concomitantly with oral medications.

Mucolytic agents

Most often, mucolytic agents are used as inhalation therapy to improve the discharge and coughing of sputum. For this purpose, the following medications are used:

Acetylcysteine (ACC), which has a mucolytic and expectorant effect. It is recommended to carry out inhalations three or four times using a 10% solution of the drug.
To improve sputum discharge, Ambroxol and Lazolvan are also used. These products have high efficiency and are used in the form course therapy 7-10 days.
If the patency of the paranasal sinuses is impaired and there is a large amount of mucus in the nasal cavity, inhalation with Rinofluimucil is indicated. The product is used in the form of a dosed aerosol, allowing for local effects of the medication.

In addition to these medications, inhaled intranasal corticosteroids (Beclomethasone, Flunisolide) are widely used. antiseptic solutions(Dioxidine), vasoconstrictors (Naphazoline, Ximetazoline), etc. It is important to note that the use of any medications must be carried out in strict compliance with indications and contraindications, and only as prescribed by the attending physician. Attempts at self-medication often lead to the development side effects from the use of medications or to the rapid progression of respiratory diseases.

Inhalation therapy is important part therapy of the respiratory system. Local delivery of drugs can significantly increase efficiency similar treatment and reduce the risks of developing systemic side effects. That being said, there are a large number of medications that can be used with nebulizers or other inhalation devices. Correct selection of patients for inhalations, taking into account their indications and contraindications, significantly improves the results of therapy and increases their level of quality of life.

There are currently many treatment options various diseases, including, for example, all kinds of lung ailments. One of them is the inhalation method, in other words, inhalation therapy. What are its specifics, and how to properly carry out treatment using inhalations?

What is inhalation

The word "inhalation" came into our speech from Latin language, translated from which it means “to inhale.” This translation very accurately reflects the essence of the entire procedure. It involves inhaling medicinal substances using special devices (for both therapeutic and preventive purposes). However, we need to make a reservation right away: inhalation therapy can be carried out not only through devices, but also in a natural way - by inhaling, for example, sea air.

When receiving inhalations through devices, medicinal substances entering the body are absorbed faster and better than if this happened in any other way. This is also considered the safest for all categories of the population. However, we will return to this issue later, but for now it is worth discussing the types of inhalation therapy - there are also many of them.

Types of inhalations

There are only five types of inhalation. These are steam - the most common inhalations, as well as dry, heat-moist, aerosol and oil. Let's talk a little more about each of these types.

Steam inhalations

This type of inhalation is considered the most common. Many have been familiar with it since childhood, because it is the easiest to use. It does not require special devices; you can breathe this way not only using inhalers, but also traditional methods- for example, over potatoes or over a teapot. The point is to inhale hot steam, to which, if the procedure is carried out using a device, special medications are also added. The steam warms up our nasal passages, throat, trachea - in general, the organs of the respiratory system, diluting the mucus in them. This type of inhalation helps well with all kinds of colds such as rhinitis, pharyngitis and the like.

For steam inhalations, medications are not required, but adding something to the steam is still possible and even recommended: eucalyptus leaves, hops, chamomile, St. John's wort. Some people add soda, but then it is important that the steam is not too hot - otherwise it will leave a burn.

Dry inhalations

Dry inhalation is also a type of inhalation therapy. This is the inhalation of medicines in powder form through special nebulizers. Exactly similar look inhalations are used, including for bronchial asthma.

Warm-moist inhalations

This type of inhalation is primarily done not at home, but in a clinic, since it requires a compressor - this involves inhaling moist air at a temperature of approximately forty degrees. However, there are special portable devices for inhalation therapy, with their help it is possible to carry out this procedure independently. Wet inhalations are usually done with simple mineral water and are aimed at eliminating phlegm.

Aerosol inhalations

Methods of inhalation therapy also include aerosol inhalations. This is spraying the medicine in the form of an aerosol using a nebulizer or a special can. This method allows the particles of the drug substance to penetrate as deeply as possible to the more “distant” respiratory organs.

Oil inhalations

To carry out this type of procedure, an inhaler is required. Hot is poured into it vegetable oil, which is then sent to the patient’s damaged respiratory organs. It relieves inflammation and, by forming a protective film on the mucous membrane, prevents its irritation. Important point: oil cannot interact with dust; such a synthesis will only worsen the situation. Therefore, it is worth taking this into account for those people who work in very polluted areas.

Indications and contraindications for inhalation therapy

Any treatment must be prescribed by a doctor. Each procedure has its own indications and contraindications. Inhalation therapy is no exception. Anyone who has ever thought about carrying it out needs to know about all the cases when the procedure is permitted or prohibited. Let's start studying these things, perhaps, with contraindications.

First and foremost: such therapy should in no case be carried out with elevated temperature. This is considered to be a mark of 37.5 and above. It does not matter what type of inhalation and what method the patient wishes to use. Any types of inhalation therapy are also prohibited when:

myocardial infarction and various heart diseases;
with nosebleeds;
pulmonary failure and bleeding;
stroke;
allergies.
steam inhalation is impossible with pleurisy;
oil can not be done if you are allergic to oils, hypertension of the second and third stages, atherosclerosis (in the latter case dry inhalation therapy is also prohibited);
at weak vessels;
warm-moisture inhalation cannot be done if you have arrhythmia or heart failure, or if you have had a stroke or heart attack (and less than eight months have passed since then);
finally, aerosol inhalation is not allowed for people with heart problems, pulmonary failure or suffering from a hypertensive crisis.

As you can see, there are plenty of contraindications. However, there are still far more indications for inhalation therapy:

All viral colds(such as ARVI, influenza, rhinitis and the like, including their complications).
Bronchitis (both acute and chronic).
Pneumonia.
Bronchial asthma.
Cystic fibrosis.
Tuberculosis.
Respiratory tract fungus.
HIV infections.
Inhalation therapy is also indicated for the prevention of postoperative conditions.

And these are not all situations when inhalations will be beneficial to the body!

Features of the procedure

The purpose of inhalation therapy is to affect the mucous membrane. It has positive result for several reasons. Yes, using inhalation in a similar way swelling and inflammation are relieved, phlegm and mucus are removed. In case of cough, spasms go away, and the mucous membrane is moistened in mandatory- regardless of what disease is being eliminated. In addition, inhalations are local therapy; some call them "grandmother's remedy." Similar features Inhalation therapy has been successfully used to treat the respiratory system both at home and in hospital settings for many years.

Rules for the procedure

There are special rules for carrying out inhalation therapy - regardless of what methods or techniques and methods the inhalation will be carried out. These rules must be followed strictly in order to get the most effective results.

It is also possible that the attending physician will have additional requirements for the procedure. In this case, of course, it is necessary to completely obey his instructions.

So, the first and most important requirement is to carry out inhalation therapy no earlier than one and a half, or even two hours after eating. However, after the procedure itself, you cannot eat or drink for another hour. You should also refrain from smoking, singing and going out into cold air during this period.

Another rule that should also be followed is the selection of comfortable clothes and a comfortable posture. During the procedure, nothing should interfere or constrain - no movement, no throat, no arms, no chest. Sitting should also be comfortable.

As a rule, the standard course of treatment should be at least five days - and preferably ten. Then the effect will be maximum. If the patient is an adult, he needs to do two or three procedures a day; if he is a child, one will be enough for him. Inhalation therapy in children is carried out for three to four minutes. Adults should spend it a little longer - five to seven. If treatment is carried out to eliminate rhinitis or any other disease of the nose and/or paranasal sinuses (no matter what method of inhalation therapy is used), you need to inhale through the nose and exhale through the mouth. If treated sore throat and/or cough, then everything happens exactly the opposite. By the way, this is logical, but it should still be clarified: any inhalation is carried out either through the nose or through the mouth - depending on what disease needs to be eliminated. Inhalations and exhalations should be light, without tension. Inhalation is a simple procedure, but it requires extreme care and maximum concentration, and therefore you should not be distracted by any extraneous things, including conversations.

Inhalation methods

There are several ways to carry out this procedure. We will not remember here about folk methods such as potatoes, a kettle and everything else, we will talk exclusively about devices for inhalation therapy. This is, firstly, a compressor - used in hospital conditions. Secondly, a nebulizer; Besides, special aerosols and inhalers, as well as a ventilator. Some also consider smoking incense as a method of inhalation therapy.

The nebulizer is the most popular device, so let’s look at it in a little more detail.

Nebulizer

What is a nebulizer? What is so special about it that distinguishes it from a regular inhaler?

The word "nebulizer" has roots in Latin and is translated into our language as "cloud". This is the whole essence of the nebulizer device - it is an inhalation device that converts medicine in liquid form into a cloud. This is the same inhaler, but with one single difference - it has a narrower action, that is, it allows the medicine to reach exactly the area where it is needed, whereas the spray spectrum of a conventional inhaler is wider. However, by and large, a nebulizer is not much different from an inhaler (which is translated from Latin as “inhale”), and therefore many manufacturers and sellers even write on packages/labels that this product is an “inhaler/nebulizer.” Only a steam inhaler cannot be classified as a nebulizer; all the others have the right to be called either this or that.

Nebulizers are static, they are located in hospitals, but in addition, there are portable devices for inhalation therapy. Asthmatics use these, because it is the nebulizer that helps them out when attacks begin. Thus, this device is used for inhalation and also for the treatment of respiratory viral diseases and cystic fibrosis.

There are two ways to spray medicine from a nebulizer to the patient - either through a mask or through a breathing tube. The latter is used more often.

Inhalation therapy with a nebulizer has its own specific requirements for how this procedure should occur. They are as follows:

The procedure is done only while sitting, you cannot bend forward.
You should not take expectorants before it.
Care must be taken to ensure that the medicine does not come into contact with the eyes.
The procedure cannot be carried out for longer than fifteen minutes.
The mask (if it is used) should fit tightly to the face.
The medicine can only be dissolved in saline solution.
Before exhaling, you should hold your breath for a couple of seconds.
At the end of the procedure, the camera of the device must be thoroughly washed in clean water and dry.

Inhalations for various diseases

As has already been mentioned several times, the spectrum of action of inhalation drugs and inhalation devices themselves is very wide; they can be used to eliminate the most various diseases respiratory system. Below we will talk about the features of treatment for some ailments.

Inhalations for asthma

For those who are not in the know, let us explain: asthma - or bronchial asthma - is a severe disease in which the bronchi are at the stage chronic inflammation. And any contact with allergic substances or the slightest stressful situation may cause an attack of suffocation. If it is not stopped immediately, it can even lead to the death of the patient. That is why every person suffering from of this disease, it is so important to have some kind of pocket inhaler. We have already found out above that for asthma you can use a nebulizer. But what other inhalers can be used during inhalation therapy? First, the spacer. This device is equipped with special valves that allow you to regulate the flow of drugs into the patient’s body - this happens only when you inhale. This device is very convenient for treating small children, but its compactness leaves much to be desired: it is quite bulky. Therefore, the spacer is not always convenient to carry.

Another type is an aerosol with a dispenser, thanks to which the medicine enters the body in certain doses. Its advantages are operational reliability and relatively low price. There are also metered-dose inhalers that dispense powder rather than liquid medication. They are also quite reliable and effective, but they cost much more.

The next type of inhaler is an auto-inhaler, which automatically delivers medication. Thus, the choice of devices for asthmatics is quite wide, and everyone can find a device that would suit them in all respects - despite the fact that experts generally recommend using a nebulizer.

Now let us briefly dwell on the advantages of inhalation therapy in the treatment of bronchial asthma. They are obvious, but they are still worth mentioning. First of all, the undeniable advantage of inhalations is the fact that the medicine enters the affected organ as quickly as possible - that is, into the bronchi, and at the same time all the necessary substances are concentrated precisely in desired area, and do not spread throughout the body. The third advantage of inhalation is that with this effect the medicine is most long time provides healing effect on the body.

Above we discussed exclusively inhalation therapy using special devices, but this procedure It can also be carried out using traditional methods, including for bronchial asthma. However, it is worth paying attention to some important aspects: Thus, you cannot use steam “folk” inhalations at the very beginning of an attack - they will not be able to relieve suffocation, but will only lead to a worsening of the condition. Besides, steam inhalations folk remedies It is prohibited for children under seven years of age.

By the way, about prohibitions: bronchial asthma also has its own contraindications, when inhalation procedures are strictly prohibited. These are the situations:

when asthma worsens, attacks occur twice a week or more often;
when there are neoplasms and/or purulent processes;
when there are tumors in the brain;
when the heart function is impaired;
when pulmonary and/or nosebleeds are common.

Inhalations for COPD

The strange abbreviation above is the name of a serious illness. Chronic obstructive pulmonary disease is a disease in which, due to the fact that the lungs are in a constant state of inflammation and therefore react acutely and very sensitively to everything that enters them, the flow of air into the organ is partially limited. In other words, this is a regular lack of oxygen. This process is irreversible, moreover, it is also progressive. Therefore, treatment must occur constantly, and inhalation therapy for COPD is one of the integral parts of this very treatment.

Usually, for COPD, it is recommended to use metered-dose inhalers, but during a period when an exacerbation of the disease occurs and a person, due to his condition, cannot control the dosage of medication, it is worth paying attention to nebulizers. The latter, by the way, during the treatment of COPD also have a beneficial effect on the heart failure that often accompanies this disease.

Inhalations for pneumonia

Pneumonia is an inflammation of the lungs, and if it is bilateral, it is also not a pleasant disease. Inhalations are here too an excellent remedy fight against infection. The rules for the procedure are standard and correspond to all those described above.

Pneumonia also has a number of contraindications to the use of inhalation therapy. Firstly, you cannot carry out similar procedures people with cardiovascular diseases. Secondly, they are also prohibited in cases of severe pneumonia, as well as in the presence of shortness of breath. You should also refrain from inhalation in all of the following cases: in the presence of pus and/or blood in the sputum, nosebleeds, tuberculosis. Lung tumors, allergies.

As for the devices used for inhalation in case of pneumonia, here too, preference is given to the nebulizer. Although, of course, it is not forbidden to use other methods - for example, steam inhalations are also very common, including folk remedies - over potatoes, for example.

Interesting facts about inhalation therapy

For the first time therapeutic effect sea air, or rather, the particles of salt in it, were described back in Ancient Rome.
The first inhaler was invented in France, and this happened back in the mid-nineteenth century. That inhaler was pressurized and operated by a hand pump. The steam inhaler first appeared in Germany, and in this way people suffering from in different forms tuberculosis.
The electric sprayer was invented almost a century later - only in the thirties of the twentieth century, and in the middle of the century ultrasonic sprayers appeared.
Using a nebulizer you can spray also herbal infusions and decoctions, but they must first be carefully filtered.
The inhaler is a personal hygiene product, and therefore should not be used the whole family or, worse, lending it to friends is not recommended. There is a risk of catching other people's illnesses.
There are inhalers whose appearance designed to interest the child. They are bright, colorful and look more like a toy than a medical device. With such a device, children are treated more willingly and more cheerfully.
The term “inhaler” itself was introduced into medicine and into speech in general by a British therapist at the end of the eighteenth century. This Briton came up with his own device for inhaling opium - he modernized a mug with a hole. Exactly this thing he called it an inhaler.
Even before our era, ancient people knew about the possibility of treatment with inhalations: for example, they inhaled henbane fumes to cure the respiratory system.

Inhalations are really effective procedure, and therefore are actively used in physiotherapy. Inhalation therapy, as a rule, does not carry any side effects and does not harm your health - of course, if you do everything correctly and follow the recommendations. So it's not in vain" grandma's remedy"Lives for years!

Inhalation is a method of introducing various medicinal substances into the patient’s body in the form of aerosols through the respiratory tract.

Aerosol is the smallest solid and liquid particles dispersed in. air. In the form of aerosols, solutions of medicinal substances, mineral waters, herbal remedies, oils, and sometimes powdered medicines can be used in physiotherapy. As a result of grinding (dispersing), medicinal substances acquire new properties that increase their pharmacological activity: a) an increase in the total volume of the medicinal suspension and b) the contact surface of the medicinal substance, c) the presence of a charge, d) rapid absorption and delivery to tissues. Other advantages of inhalation therapy are: absolute painlessness of drug administration, elimination of their destruction in the gastrointestinal tract, reduction in the frequency and severity of side effects of drugs.

According to the degree of dispersion, five groups of aerosols are distinguished:

1) highly dispersed(0.5-5.0 microns) - practically do not settle on the mucous membrane of the respiratory tract, they are freely inhaled and settle mainly on the walls of the alveoli and bronchioles;

2) medium-dispersed(5-25 µm) - settle mainly in the bronchi of the 1st and 2nd order, large bronchi, and trachea;

3) low-disperse(25-100 microns) - very unstable (especially droplets), settling on the surface, quickly connecting with each other and eventually returning to the original state of a regular solution;

4) small-droplet(100-250 microns) - almost completely settle in the nose and oral cavity;

5) large-panel(250-400 microns).

These features of aerosols are taken into account when choosing the degree of dispersion of aerosols for the treatment of diseases of various localizations. For the deposition of aerosols in the respiratory tract, the speed of their movement is important. The higher the speed, the fewer aerosol particles settle in the nasopharynx and oral cavity. It is believed that on average 70-75% of the medicine used is retained in the body.

To increase the stability of aerosols in the air and increase their biological effect, a method of forced recharging with an electric charge has been developed. Such aerosols are called electroaerosols. Electric aerosol particles have a free positive or negative charge, and the presence of a free electric charge brings their action closer to the action of air ions.

Routes of administration of aerosols in medicine:

intrapulmonary(intrapulmonary) - for their effect on the mucous membrane of the respiratory tract and the ciliated epithelium of the lungs (for diseases of the paranasal sinuses, pharynx, larynx, bronchi and lungs);

transpulmonary - absorption of a drug from the surface of the mucous membrane of the respiratory tract, especially through the alveoli, for a systemic effect on the body, while the rate of absorption is second only to intravenous infusion of drugs (for the administration of cardiotonic drugs, antispasmodics, diuretics, hormones, antibiotics, salicylates, etc. );

extrapulmonary(extrapulmonary) - application on the surface of the skin (for wounds, burns, infectious and fungal infections of the skin and mucous membranes);

parapulmonary(parapulmonary) - exposure to air and objects, animals and insects for disinfection and disinsection. In clinical practice highest value have intrapulmonary and transpulmonary methods of administering aerosols.

Physiological and therapeutic effects of aerosols. The effect on the body is determined by the drug used, the choice of which determines the nature of the pathological process and the purpose of the effect. Alkalies or alkaline mineral waters, oils (eucalyptus, peach, almond, etc.), menthol, antibiotics, proteolytic enzymes, bronchodilators, glucocorticoids, phytoncides, vitamins, decoctions and infusions of medicinal herbs, etc. are more often used. Aerosols act primarily on the mucous membrane of the respiratory tract along its entire length, on the microorganisms located here, as well as on the production of mucus. Their most pronounced absorption occurs in the alveoli, less intense - in the nasal cavity and paranasal sinuses. When absorbed, aerosols have not only a local, but also a reflex effect through the receptors of the o6oHHfelenic nerve, receptors of the bronchial mucosa and bronchioles.

As a result of exposure to aerosols, the permeability of the boonchoalveolar tree improves. This occurs due to the use of mucolytic drugs and cough reflex stimulants, as well as due to the action of a moistened and warmed inhaled mixture. Gas exchange and vital capacity of the lungs increase, as well as the rate and volume of drugs entering the blood. At the same time, tissue blood supply and metabolism are improved.

Electrical aerosols (compared to aerosols) have a more pronounced local and general action, since an electric charge enhances the pharmacological activity of substances and changes the electrical potential of tissues. Preference is given to negatively charged aerosols.

The temperature of the aerosol is important. Hot solutions (above 40°C) suppress the function of the ciliated epithelium. Cold solutions (25-28°C and below) cool the mucous membrane of the respiratory tract and can cause an attack of suffocation in patients with bronchial asthma. The optimal temperature of aerosols and electric aerosols is 37-38°C. The pH of the inhaled solution (optimal 6.0-7.0) and the concentration (not higher than 4%) of the drug in it are also essential.

When aerosols are used externally, the area of active contact of the medicinal substance with the pathological focus increases, which accelerates its absorption and the onset of the therapeutic effect.

Features of the technique. For clinical purposes, an aerosol is obtained by dispersion - grinding the drug using mechanical and pneumatic methods. The most promising method for preparing aerosols is using ultrasound.

Portable devices (individual) - ultrasonic inhalers (“Fog”, “Breeze”, “Monsoon”, “Diso-nik”, “Taiga”, UP-3.5, “Thomex”, “Nebatur”, “UltraNeb-2000” ), steam (IP-1, IP-2, "Boreal") and pneumatic (IS-101, IS-101P, "Inga", "PulmoAide", "Thomex-L2"). Stationary devices - "UI-2, "Aerosol U-2", "Aerosol K-1", TUR USI-70, "Vapozone" are intended for group aerosol therapy.

To obtain electroaerosols - portable devices “Electroaerosol-1” and EI-1, stationary devices for group inhalations GEK-1 and GEG-2.

Group inhalations are based on the creation of a uniform fog in the air of a limited room and are intended for simultaneous exposure to a group of patients; individual - for direct administration of an aerosol into the respiratory tract of one patient. Inhalation therapy is carried out in a specially designated room (inhalation room) with an area of at least 12 m2, which must be equipped with a supply and exhaust ventilation system that provides 4-10 times air exchange.

Types of inhalations: steam, heat-moist, moist (aerosols at room temperature), oil and powder inhalations.

Steam inhalations are carried out using a steam inhaler (type IP-2), but they can also be carried out at home without a special device. Inhalations are prepared by obtaining steam from a mixture of easily evaporating medications (menthol, eucalyptus, thymol) with water, as well as from a decoction of sage and chamomile leaves. The vapor temperature is 57-63°C, but when inhaled it decreases by 5-8°C. The inhaled steam causes an increased rush of blood to the mucous membrane of the upper respiratory tract, helps restore its function and has an analgesic effect.

Steam inhalations are used for diseases of the upper respiratory tract. Due to the high temperature of the steam, these inhalations contraindicated with severe forms of tuberculosis, with acute pneumonia, pleurisy, hemoptysis, arterial hypertension, coronary heart disease.

Warm-moist inhalations carried out at an inhaled air temperature of 38-42°C. They cause hyperemia of the mucous membrane of the respiratory tract, thin out viscous mucus, improve the function of the ciliated epithelium, accelerate the evacuation of mucus, suppress persistent cough, and lead to free expectoration. They use aerosols of salts and alkalis (sodium chloride and bicarbonate), mineral waters, anesthetics, antiseptics, hormones, etc. After using them, the patient must cough in a drainage position, do breathing exercises or vibration massage of the chest. Contraindications requirements for heat-moisture inhalations are the same as for steam inhalations.

Wet inhalations - the medicinal substance is sprayed using a portable inhaler and introduced into the respiratory tract without preheating; its concentration in the solution is higher and the volume is smaller than with warm-moist inhalations. Anesthetics are used and antihistamines, antibiotics, hormones, phytoncides.

Oil inhalations - spraying heated aerosols of various oils. Oils of plant origin (eucalyptus, peach, almond, etc.) and animal origin (fish oil) are used. The use of mineral oils (vaseline) is prohibited. When inhaled, the oil is sprayed, covering the mucous membrane of the respiratory tract with a thin layer that protects it from various irritations and prevents absorption harmful substances into the body. Oil inhalations have a beneficial effect in inflammatory processes of a hypertrophic nature, reduce the feeling of dryness, promote the rejection of crusts in the nose and throat, and have a beneficial effect in acute inflammation of the mucous membrane of the respiratory tract, especially in combination with antibiotics.

Inhalation of powders(dry inhalations, or insufflations) are used mainly for acute inflammatory diseases of the upper respiratory tract; for this, the sprayed drug is mixed with dry hot air. Powdered antibiotics, sulfonamides, vasoconstrictors, antiallergic, and anti-influenza drugs are used. For spraying, use a powder blower (insuflator), sprayers with a balloon or special sprayers (spinhaler, turbohaler, rotahaler, dischaler, isihan ler, cyclohaler, etc.).

Ultrasonic inhalations are based on obtaining medicinal solutions using ultrasound. Ultrasonic aerosols are characterized by a narrow spectrum of particles, high density and stability, low oxygen concentration, and deep penetration into the respiratory tract.

All types of hardware inhalations are carried out daily, only some - every other day. Duration of inhalation - from 5-7 to 10-15 minutes. The course of treatment is prescribed from 5 (for acute processes) to 20 procedures. If necessary, repeat the course after 10-20 days.

Children can be prescribed inhalations from the first days of life to prevent and treat respiratory diseases.

Inhalation therapy has long been one of the main components in the prevention and treatment of acute and chronic diseases of the upper respiratory tract.

Devices intended for aerosol therapy are divided into portable (usually used at home) and stationary - for inhalation in medical institutions. The choice of inhaler depends on the purpose for which inhalation therapy is prescribed.

If the drug must be delivered to the upper respiratory tract, use a compressor-type inhaler. The medicine is supplied in it along with the escaping air stream. The aerosol that is formed when using such inhalers contains drug particles that are easily deposited in the upper respiratory tract. A compressor type of medication supply is used for oil, moist, heat-moisture and steam inhalations.

Nebulizers are highly effective devices for treating the central and upper respiratory tract. This is essentially a compressor-type inhaler. He delivers the inhaled mixture through a special nozzle, which allows you to obtain an aerosol or “cloud” with high content fir oil particles. Nebulizers are used to deliver antibiotics, mucolytics and other drugs into the respiratory tract.

Ultrasonic inhalers are used if it is necessary for the medication to penetrate small bronchi (this is required for acute and chronic bronchitis, pneumonia, bronchial asthma). The aerosol produced by such inhalers contains very small particles of the drug. However, it should be noted that the structure of some substances is completely or partially destroyed when finely sprayed, which leads to a loss or reduction in the therapeutic effect of inhalation.

Types of inhalations

1. Steam inhalations can be performed without a special device (steam inhaler). Such inhalations are prepared from easily evaporating medications ( fir oil, menthol, eucalyptus and others) with water. The temperature of the vapor should be 57-63 degrees, but when inhaled it decreases. Such inhalations are contraindicated in case of pleurisy, acute pneumonia, severe forms tuberculosis, arterial hypertension, hemoptysis due to high temperature pair.

2. Warm-moist inhalations thin out viscous mucus, improve blood flow to the mucous membrane of the respiratory tract, and improve the function of cilia, which push mucus out of the bronchi. For this type of inhalation, solutions of alkalis and salts (soda, saline and others), hormones, mucolytics, and antibiotics are used. The temperature of inhaled air is from 38 to 42 degrees. Contraindications are the same as for steam.

3. For wet inhalations, anesthetics and antihistamines, phytoncides, hormones, and antibiotics are used. The concentration of the drug in the solution is greater than with warm-moist inhalations. Such inhalations are tolerated quite easily, so they are prescribed to those patients for whom heat-moist and steam inhalations are contraindicated.

4. Oil inhalations are carried out using heated air. Fir oil, eucalyptus, almond, peach and other oils are used. The use of mineral oils is prohibited! Oil inhalations promote the rejection of crusts in the throat and nose and reduce the feeling of dryness. However, such inhalations are prohibited for people in contact with a large number dust (including tobacco). Since dust, mixing with oil, forms plugs, which, in turn, clog the lumen of the bronchi.

5. The peculiarity of ultrasonic inhalations is that thanks to ultrasound, aerosols with a smaller particle size are formed. A small medicinal substance is delivered to the respiratory tract, which significantly increases the effectiveness of inhalation. The attending physician will select an individual treatment regimen for you: determine the duration and number of sessions, taking into account the type of disease and its severity.

Inhalation therapy allows you to deliver the drug directly to the pathological focus and avoid the occurrence of side effects that are typical for other methods of drug administration.

The use of fir oil as one of the components in inhalations, clinics, and hospitals will significantly increase the effectiveness of treatment for various diseases of the upper respiratory tract. One thing to remember: filling your inhaler with fir oil for several days is not recommended. Only for a day, maximum two. In the inhaler goes fast oxidation process, light fractions evaporate, and hence the therapeutic effect suddenly disappears, fir oil loses its softness and becomes an irritant.

Treatment and prevention of diseases by inhalation of artificially sprayed medicinal substances or air saturated with salts and essential oils.

Main goal inhalation therapy is to achieve maximum local therapeutic effect in the respiratory tract with minor manifestations of systemic action.

Main tasks inhalation therapy is considered to be: improvement of the drainage function of the respiratory tract; sanitation of the upper respiratory tract and bronchial tree; reducing swelling and stimulating regeneration; decreased activity inflammatory process; relief of bronchospasm; impact on local immune reactions respiratory tract; improvement of microcirculation of the mucous membrane of the respiratory tract; protection of the mucous membrane from the action of industrial aerosols and pollutants.

The most common types of inhalations are steam, heat-moist, wet, oil, air, ultrasound and insuffulation.

Insufflation– or inhalation of dry medicinal substances.

Shown in acute and chronic runny nose, flu, sinusitis, adenoiditis, tonsillitis, chronic tonsillitis, acute laryngitis, tracheitis, pharyngitis, as well as pulmonary tuberculosis.

Steam inhalations are the most accessible type of inhalation. They are carried out using steam inhalers.

Shown: for acute and chronic diseases nasal cavity, middle ear, throat, acute and chronic diseases of the trachea and bronchi, influenza and acute respiratory diseases, occupational diseases respiratory organs.

Contraindicated in severe forms of tuberculosis, acute pneumonia, pleurisy, hemoptysis, arterial hypertension, coronary disease heart, hypertrophy and polyposis of the mucous membranes of the respiratory tract.

Wet inhalations - the medicinal substance is sprayed using a portable inhaler and introduced into the respiratory tract without preheating.

Indications: prevention of drying out of the mucous membrane of the tracheobronchial tree under conditions of prolonged artificial ventilation; respiratory hygiene in the presence of a tracheostomy; prevention of bronchospastic reaction associated with physical activity, relief of swelling of the respiratory tract; symptomatic treatment upper respiratory tract diseases.

Warm-moist inhalations- cause hyperemia of the mucous membrane of the respiratory tract, dilute sputum and stimulate mucociliary clearance, accelerate the evacuation of mucus, suppress persistent cough, improve the drainage function of the bronchi. Shown for subacute and chronic diseases of the nose, middle ear and throat, acute and chronic diseases of the trachea and bronchi, lung abscess, pneumosclerosis, bronchial asthma, influenza and acute respiratory diseases, occupational respiratory diseases.

Oil inhalations are based on spraying with preventive and medicinal purposes heated various oils, which have trophic, reparative, regenerative and bronchoprotective effects.

Oil inhalations shown at acute inflammation mucous membranes of the respiratory tract, with swelling and hypertrophy of the mucous membranes, with unpleasant sensations dryness in the nose or larynx, as well as for preventive purposes.

Contraindicated when the drainage function of the bronchi is impaired and in industries with large amounts of fine dust.

Air inhalations are carried out by spraying medicinal substances contained in a can with easily evaporating gas (propellant) or compressed air.

Shown for subacute and chronic diseases of the trachea and bronchi, severe edema, acute pneumonia in the convalescence stage, bronchial asthma, occupational diseases of the bronchi and lungs, in conditions after lung surgery, accompanied by complications of a suppurative nature.

Ultrasonic inhalations are based on the breakdown of liquid using ultra-high frequency mechanical vibrations or ultrasound.

Ultrasonic inhalations shown for lung abscess, pneumosclerosis, pneumonia in the convalescence phase, occupational lung diseases.