COPD, Asthma, and YOU: Tabletop and Portable Nebulizers

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Are you deciding or helping someone decide which nebulizer to buy? There are so many choices that the process can be confusing. Here are a few considerations to help you make the most appropriate decision. Note: Before making a decision to purchase, please consult your doctor or healthcare provider for guidance.

To simplify matters, we will discuss tabletop and portable nebulizers. Compared to inhalers that require deep breaths that a person should hold for a few seconds, nebulizers deliver measured amounts of medication more effectively during a few minutes.

Tabletop (or stationary) nebulizers are larger and not meant to be carried around. They typically require access to an electrical outlet to operate. Portable nebulizers are smaller and lighter, and they typically run on batteries so that they can be used away from home.

Basic Lifestyle

If you seldom leave home, for whatever reason, a tabletop nebulizer might be advisable most of the time. These machines can deliver precise amounts of mediation deeply into lungs and bronchial tubes, usually 10 to 20 minutes, with little effort. Newer models are lighter and less noisy. Most tabletop nebulizers use oxygen, compressed air, or ultrasound to vaporize liquid medication into tiny droplets for delivery to the lungs. Since they can take several minutes to deliver the correct dose, using them can be difficult for active children.

If you lead a more active lifestyle that involves outdoor activity, work away from home, or traveling, a portable nebulizer might be right for you. Most portable devices use ultrasound to vaporize liquid medications. Many use lithium or rechargeable batteries as a power source; a few also feature an electrical plug-in option. They can vary widely in size, weight, and ease of maintenance.

Many people purchase both a tabletop and portable nebulizer. This allows them maximum flexibility to enjoy life.

When selecting a portable nebulizer, try to be mindful of the type and frequency of activity that you engage in. If you work or travel outside your home often, you might prefer a very small, easy to use and maintain device.  

Level of Breathing Difficulty

The level of breathing difficulty that you experience can also influence your decision. Depending on the dosage prescribed by your doctor, tabletop nebulizers might be recommended for administering larger doses. This is also important to consider if your COPD advances in severity.

Most portable nebulizers can deliver prescribed doses and types of medication for those who have COPD or asthma. If you have difficulty breathing deeply and holding your breath, a portable nebulizer will probably be more effective than an inhaler.

Kind of Medication Needed

Both tabletop and portable nebulizers can deliver most medications that are prescribed for COPD and asthma. These medications—usually bronchodilators and corticosteroids—must be in liquid form so that compressed gas or ultrasound can vaporize them.

Some nebulizers rely on ultrasound alone (without a micromesh) to vaporize the medication. This process can deliver heat to the medication and should be avoided for use with specific medications. Please check with your doctor about whether the medications prescribed for you can be used with ultrasonic devices.

Nebulizers that use a vibrating mesh to create an extremely fine mist that does not transfer heat to the medication and are, therefore, usually appropriate for use with all liquid medications.

Ease of Care

All nebulizers require cleaning and periodic maintenance. Medication cups, mouthpieces or masks, and tubing (if any) should be thoroughly cleaned according to manufacturer’s directions to prevent bacterial buildup.

Tabletop and portable nebulizers that use tubing will involve the most effort in keeping them clean. Portable nebulizers without tubing are typically easier to clean and maintain. Cleaning all types of nebulizers will require some disassembly of the device.

Easy access to an electrical power source is needed for nebulizers that must be plugged in. For portable nebulizers that use batteries, a supply of extra batteries should be kept on hand. You should also plan for a way to charge devices that use rechargeable batteries.

Please be sure you know who will be responsible for cleaning and maintaining your nebulizer. This must be done correctly and frequently as directed by the manufacturer to prevent bacterial infection.

FDA Clearance

Knowing that a nebulizer that you’re thinking of buying has FDA clearance can bring peace of mind. The Food and Drug Administration (FDA) requires manufacturers of Class II medical devices, such as nebulizers, to receive “clearance” to market such devices. This means that the manufacturer must submit a significant amount of documented data demonstrating that their product meets standards of other approved devices for safety and effectiveness.

Manufacturers must register their devices annually and follow good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

For an explanation of FDA clearance procedures, please visit the FDA Premarket Notification 501(k) page.

Though manufacturers should follow FDA guidelines, some might not. Look for those devices manufacturers that indicate their device has been FDA cleared. To find out whether a device that you are considering for purchase has been cleared by and is currently registered with the FDA, visit the FDA’s Establishment Registration and Device Listing page and enter the company and/or device name in the online form.

Budget

The cost of tabletop and portable nebulizers varies widely. Portable nebulizers typically cost a bit more than tabletop models. When shopping, be sure to include the cost of accessories, cleaning supplies, and replacement items in your calculations.

Nebulizers prescribed by a healthcare provider are considered “durable medical equipment” (DME). Your health insurance, including Medicare or Medicaid, might pay all or part of the cost, including the cost of periodic supplies.

Important: Check with your insurance provider or Medicare/Medicaid provider before you purchase any DME. In addition, your prescribing doctor must be in-network with your insurance carrier or a participant in Medicare/Medicaid.

Additional Resources

Helpful information is available at the following online sites:

Healthline: Nebulizers for Chronic Obstructive Pulmonary Disease

Healthline: Using a Nebulizer

Medicare.gov: Nebulizers & nebulizer medications

WebMD: Nebulizer (article provides basic information about types and use)