Cleaning small-volume nebulizers: the efficacy of different reagents and application methods

Aerosol inhalation is an important treatment for immobilized patients living at home. Aerosol application of medicine can reduce symptoms of acute and chronic respiratory tract diseases. However, aerosol therapy performed using small-volume nebulizers (SVNs) may induce bacterial colonization and increase pneumonia risk. The proper cleaning of SVNs is important to prevent pneumonia.

This experimental study was designed to compare the cleaning efficacy of two different cleaning reagents and three different cleaning methods with regard to SVNs.

Tap water and sterile distilled water were used as the two cleaning reagents. The three different cleaning methods included (a) soaking the nebulizer for 10 minutes, (b) rinsing the nebulizer for 30 seconds, and (c) soaking the nebulizer for 10 minutes, changing the water, and then rinsing reagent for 30 seconds. There were 13 groups in the study. Six groups were assigned into the noncontaminated and the remaining seven were contaminated with Escherichia coli. One contaminated group was assigned with noncleaning as a positive control group, and 12 groups were assigned into each of the unique cleaning reagent + cleaning method combinations. Evaluations of microbe presence were performed by taking samples from nebulizers after cleaning.

Results showed insignificant differences among cleaning reagent efficacies (p = .186) and significant differences among cleaning methods (p < .001). The soak-then-rinse method was found to provide significantly better results in comparison with the other two methods.

On the basis of the results, we suggest that SVN cleaning procedures should focus on the cleansing method. Findings provide evidence to support that the soak-then-rinse method may the preferred technique to use in cleaning SVNs.