Problemen met gebruik, reiniging en onderhoud van vernevelapparatuur in de thuissituatie

To determine whether jet nebulizers used at home for the treatment of children with asthma are used optimally.

Design

Descriptive.

Setting

Outpatient clinic for child pulmonary diseases of the Academic HospitalSophia Children's Hospital Rotterdam and outpatient clinic for child diseases of the Baronie Hospital Breda, the Netherlands.

Method

Thirty-nine children aged 0-13 years and their parents were interviewed at home, and medication cup, saline and aerosol were cultured for bacterial analysis. The pressures of the compressor and nebulizer were measured with a manometer, and the particle size of the aerosol of 10 jet nebulizers was measured by laser technique.

Results

The suppliers of the nebulizer did not provide clear instructions on user-related aspects and technical maintenance of the jet nebulizer. Many patients used damaged and poorly functioning, contaminated jet nebulizers. Contamination by potentially pathogenic micro-organisms was present in 50 of the saline, medication cups and aerosols (Klebsiella, Enterobacter, Pseudomonas, Serratia, Escherichia coli). The operating pressure of compressor and nebulizer was below the requirements in more than 50 of the jet nebulizers. In addition, we found that the aerodynamic mass median diameter increased considerably as the nebulizer became older. In 610 nebulizers the particle size was below 5 µm.

Conclusion

A periodical checkup of user-related aspects and technical quality of jet nebulizers is necessary. The qualitiy of the instruction to users about the procedure for cleaning and maintenance of the jet nebulizer should be improved.