Diseases of the lower respiratory tract
The bronchitis
The bronchial tree may be secondarily affected by inflammatory events started to load of the upper air, whether in nature irritation (diseases cooling) or infectious frankly, less often is the site of a primary disease, acute or chronic.
The Acute bronchitis recognize causes irritation, infectious or allergic.
Many substances in the form of gases or steam, or suspended in the air, can exert a harmful action on the bronchial mucosa: ammonia, acetone, acetic acid, hydrochloric acid, sulfur dioxide, can cause a state of acute flogosi too serious. The inhalation of air or water vapor at high temperature can seriously harm the bronchial mucosa.
Among the causes infectious find many types of viruses and bacteria and, less frequently, the fungi (or fungi).
Excluding the bronchial asthma, you may have flogosi allergic bronchial mucosa in the course of other allergic diseases (eg, in the course of allergic rhinitis, hay fever cd).
Chronic bronchitis responds to repeated episodes of acute bronchitis or arises as such.
Among the causes of chronic bronchitis, infectious factors are less important than the acute form, while those factors are paramount, which may chronically compromise the structural and functional integrity of the bronchial mucosa.
Among these factors, a very important place occupies smoking In fact, chronic bronchitis affects heavy smokers, with few exceptions, has considerable importance to air pollution which is attributed to the increased frequency of diseases in highly industrialized areas, as the irritating particles remain suspended longer in air (smog ).
Climatic conditions, which have more weight as a factor, have the role of driver for the frequent relapses.
The bronchitis is characterized by a symptom constantly present, although in varying shape and intensity: a cough with sputum.
The aerosol therapy and the route of choice for the administration of drugs antibronchitici: antiphlogistic, balsamic, flowing, expectorant, antibiotics can be sprayed, resulting in their high local concentration with therapeutic effect would be achieved only by means of administration of high doses of medicine generally, with the side effects and reactions to all known. Especially in chronic forms the aerosol performed regularly prevents recurrent relapses, and the chronic intake of drugs without harming the body. It is also useful as a premedication in respiratory rehabilitation.
Bronchopneumonia
Occur as a complication of acute bronchitis or primitive, more frequently have viral origin and involve both lungs.
Pneumonia
Usually affecting a lobe of one lung and originate predominantly bacterial.
Given the severity of clinical presentation, pneumonia and bronchopneumonia in need of therapy administered by general; the Aerosoltherapy However even in these cases has an important role, especially during their resolution to encourage the sputum.
The aerosol in the lower airways
Inhalation therapy, which allows the drug to settle in high quantities TARGET ORGAN, is widely used in the treatment of local disease of the airways smaller. In fact, thanks to features of non-invasiveness and ease of use, is the method of choice in the treatment of asthma focused, of broncho-pulmonary diseases in general and cystic fibrosis.
The Benefits
The primary advantage of topical therapy , And engaging only the portion to be treated without assimilation of medicine for systemic (organ), is to have no side effects that could be causing reactions that depriving the body of the diseased area right drug.
The effectiveness
The effectiveness of the solutions prescribed by your doctor is the particle size of drug nebulised that they have a size between 1 and 5 microns (one micron is one millionth of a meter, just over hundredth of the diameter of a hair) in order to deposit in the peripheral respiratory dell'albero. The drug thus reaches nebulized directly malata area, reaching unchanged and proper concentration.
How to get the result
Dell'aerosolterapia The goal is to deposit an amount of therapeutic drug level tracheo-bronchial. The amount of drug that reaches the lungs depends on two factors: the patient and the nebuliser.
Not being able to intervene on many variables related to characteristics of the patient, it is essential to reduce the variability from the employee used standardizing the methods of use. The ampoule is the most important because it lays the formation of spray particles whose size is therefore crucial to have the maximum therapeutic outcome. The mask is a very important element for the effectiveness of inhaled therapy. There are two parameters to standardize the methods of use of the aerosol.
Respirable fraction (PORR) *
And 'the percentage of spray particle size from 1 to 5 microns, which can therefore reach the lower airways. (NOTE: It is important that the aerosol particles to produce up to 10 microns in size especially if you intend to treat diseases of the upper air, remember that very little mist reaches the lower airways and is essential to treat diseases related but does not stop in upper airway resulting unnecessary to treat a trivial effect).
Ex: Respirable fraction = 90% means that 90% of the volume nebulized by a particular unit is composed of particles of between 1 and 5 microns.
* PORR: Percent of Output in Respirable Range (respirable fraction).
Amount of drug available at the nozzle within the respirable fraction.
NB: For the drug is the actual active ingredient, not the volume of nebulized solution or suspension, because it is known that the volume nebulized may not contain the active ingredient
(ie the solvent is sprayed, not the solute)
** ADRR: Amount of Drug in Respirable Range.
The ADRR (expressed in mcg) is the most objective data to determine accurately and precisely the behavior of the nebulizer with respect to administration of a particular drug.
A nebuliser equal the same ADRR can be obtained by changing the concentration of starting or changing the time for nebulization. In other words, starting from a low concentration is necessary to prolong the time dell'aerosolterapia the contrary, starting from a higher concentration simply a shorter time to deliver the same amount of active ingredient. At the same concentration and starting with various nebulisers ADRR the same can be obtained at different times of spraying.