What to Know About Portable Nebulizers for Asthma

Table of Contents
View All
Table of Contents

Nebulizers are small machines that convert liquid asthma medication into an aerosolized mist that gets inhaled directly into the lungs. These devices can be used to deliver maintenance treatment to keep asthma under control or during an asthma attack to halt symptoms such as wheezing. Nebulizers offer several advantages—especially for small children or older adults with asthma—which is why they may be used instead or In conjunction with metered dose inhalers (MDIs) or dry powdered inhalers (DPIs).

Little boy using a nebulizer
anadaBGD / Getty Images

Uses

A nebulizer machine takes medication in a liquid form and turns it into a fine mist that can be breathed into the lungs through a mask or mouthpiece. You just breathe in and out, and the medicine goes into your lungs. The medicines and moisture ease breathing problems and help loosen lung secretions.

Depending on which medication is prescribed, the nebulizer treatment will serve one of two goals:

  • Provide quick relief of asthma symptoms: This is usually accomplished with short-acting beta-agonists (SABAs), called "rescue medications" because they stop an asthma attack in progress.
  • Prevent asthma attacks: Long-term controller medications may be inhaled daily to reduce airway inflammation and prevent frequent asthma attacks.

Nebulizers may be chosen over MDIs or DPIs as the means for delivering these medications because they are easier to use. This is especially true if the medication is being administered to infants and young children or adults who have difficulty using small inhalers.

When used incorrectly, MDIs or DPIs can leave medication in the back of the mouth instead of delivering it into the lungs. Aside from providing inadequate treatment, this can lead to side effects like hoarseness and thrush. It's also possible to push down multiple times on an inhaler, which would deliver more than the recommended dosage.

With a nebulizer, medication is pre-measured. The patient only needs to breathe normally through a mask or mouthpiece and the correct dose enters the lungs.

Types of Nebulizers

There are several types of asthma nebulizers to choose from. While different nebulizers have certain properties that may make them more or less desirable, no specific nebulizer has been shown to be better than another for asthma.

Healthcare providers may not necessarily think about prescribing or recommending a particular type of nebulizer, so it is worthwhile to discuss the differences between devices with your healthcare provider. Nebulizers that are more convenient for your lifestyle or better meet your or your child's needs are going to provide a better overall outcome.

Jet Ultrasonic Mesh
More prep/slower Faster treatment delivery Fastest treatment delivery
Least costly More expensive Most expensive
Bulky Compact/portable Compact/portable
Must be plugged in Plug-in or battery-operated Plug-in or battery-operated

Jet Nebulizers

Jet nebulizers are the most commonly prescribed because they are easy to use and inexpensive.

These devices have a small plastic cup with an attached mouthpiece where the liquid medicine is placed. The mouthpiece is connected by plastic tubing to a motorized machine that provides a stream of compressed air. The air flows into the tubes, passes through the cup, and the medication is converted to a fine mist that can then be breathed into the lungs.

Jet nebulizers are bulky and require an electrical source, which can be a problem when you are traveling. Some medication must be mixed with saline, which takes some extra time. Finally, compared to other types of nebulizers, jet nebulizers are significantly noisier.

There are different types of jet nebulizers. The most effective are breath‐enhanced open‐vent nebulizers, which better ensure that the complete dosage of a medication is inhaled, compared to open‐vent nebulizers. In fact, research has shown that less than half of the dose of common inhaled steroids makes it into your lungs when an open-vent nebulizer is used.

With breath‐enhanced open‐vent nebulizers, there is less likelihood of medicinal vapor escaping and failing to make it into the lungs. However, these types of nebulizers require you to be able to inhale powerfully. They may not be as effective, therefore, with infants or very young children.

Ultrasonic Nebulizers

Ultrasonic nebulizers use ultrasonic waves to aerosolize asthma medication. They deliver treatment significantly faster than jet nebulizers and do not require mixing saline with your asthma medication.

Since they do not require a compressor, ultrasonic nebulizers are much more compact. They can be operated by battery, which makes them more portable.

Mesh Nebulizers

Mesh nebulizers vibrate a small mesh membrane at very high speeds. As liquid medication is forced through tiny holes in the mesh, an aerosol is produced.

Mesh nebulizers are the fastest and most expensive of the nebulizers. Like ultrasonic nebulizers, battery-operated models are available, making these portable nebulizers very convenient.

Because of the vibrating mesh, however, mesh nebulizers need to be cleaned frequently to avoid clogging of the small openings used to create the mist.

Healthcare providers often recommend that you have a backup nebulizer, since a mesh nebulizer can fail more often than other types of machines. This creates added expense.

Asthma Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Child

Deciding to Use a Nebulizer

Before deciding whether using a nebulizer is right for you and choosing which type you'll use, discuss your condition and medical needs with your healthcare provider. Factors such as cost and convenience should also be considered.

In addition to supporting children and older adults with treatment, nebulizers are sometimes preferred for other reasons, but there are disadvantages to using a nebulizer too.

Pros of Nebulizers
  • Less room for error: Only measured medication can be inhaled.

  • Requires less coordination: Infants and disabled adults can be assisted.

  • Long-term use: Medication needs to be replenished, but the device can be used for several years.

Cons of Nebulizers
  • Takes longer: Time for prepping and inhaling can be 15+ minutes versus ~1 minute for inhalers.

  • Less convenient: Bulky machine may need to be plugged, whereas an inhaler is pocket-size.

  • More expensive (in most instances)

Precautions

Studies of MDIs versus nebulizers show that nebulizers may significantly increase your heart rate and the possibility of tremors compared to MDIs. There may also be a greater need for hospitalization with nebulizers.

If you are at risk for tachycardia and arrhythmias, be sure that you discuss these risks with your healthcare provider.

How to Operate a Nebulizer

Follow these specific steps to use your nebulizer:

  1. Set up your machine in a spot where you can comfortably sit for up to 15 minutes and where there is a power source (if needed).
  2. Wash your hands before using the nebulizer.
  3. Pour measured medication into the nebulizer cup and attach the mask or mouthpiece to the cup.
  4. Connect the tubing from the cup to the machine's body and switch the nebulizer on.
  5. Place the mouthpiece between your teeth and seal your lips over it, or put the mask over your face. Within seconds, a light mist will be emitted.
  6. Breathe normally through your mouth. Around every fifth breath, take a slow, deep inhale and hold for two or three seconds.
  7. Continue until the mist dissipates and all the medication is gone from the cup.

After Use

It's very important to disinfect the nebulizer equipment after a treatment.

Wash the mouthpiece or mask with soap daily; rinse and dry thoroughly before the next use. Rinse the nebulizer cup and let it air dry. You should not wash the tubing.

Side Effects

For some people, the medication delivered via a nebulizer can produce immediate side effects:

  • Dizziness: If you become dizzy while using the nebulizer, slow your breathing and pause the treatment. If dizziness occurs after a treatment, remain at rest until the sensation passes.
  • Jitteriness: Feeling shaky or jittery after treatment is common, but the sensation should pass soon.

If these side effects continue, contact your healthcare provider.

A Word From Verywell

It's helpful to work with your healthcare provider to develop a successful routine for using a nebulizer. This is especially important if you are helping a small child or older adult use the device; intimidation about the noise it makes and hesitancy about the need to use a mask are common.

Medical supply companies now offer attachments that make nebulizers more fun to use for children and that will allow you to ensure that a treatment session results in a full dosage being properly inhaled.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Academy of Allergy, Asthma & Immunology. Inhaled asthma medications.

  2. Máiz Carro L, Wagner Struwing C. Benefits of nebulized therapy: basic concepts. Arch Bronconeumol. 2011;47 Suppl 6:2-7. doi: 10.1016/S0300-2896(11)70028-X

  3. Murayama N, Murayama K. Comparison of the clinical efficacy of salbutamol with jet and mesh nebulizers in asthmatic children. Pulm Med. 2018;2018:1648652. doi:10.1155/2018/1648652

  4. Usmani OS, Lavorini F, Marshall J, et al. Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes. Respir Res. 2018;19(1):10. doi:10.1186/s12931-017-0710-y

  5. Moriates C, Feldman L. Nebulized bronchodilators instead of metered-dose inhalers for obstructive pulmonary symptoms. J Hosp Med. 2015;10(10):691-3. doi:10.1002/jhm.2386

  6. The Cleveland Clinic. Home nebulizer instructions.

Additional Reading

By Pat Bass, MD
Dr. Bass is a board-certified internist, pediatrician, and a Fellow of the American Academy of Pediatrics and the American College of Physicians.