Guideline recommendations for the use of nebulized inhalation therapy in pediatrics

  Nebulized inhalation therapy is now widely used in pediatric clinics and plays a certain role in the adjuvant treatment of respiratory diseases in children, but through clinical use in recent years, it has been observed that there is the phenomenon of abuse, and this phenomenon is becoming more and more serious, and its negative effects or side effects occur from time to time.  As a doctor, especially a pediatrician or respiratory doctor, should clearly know the following two points: a. The indications for the use of nebulized inhalation therapy should be strictly mastered, and at the same time, the drugs required for nebulized inhalation should be correctly selected according to the condition. For inhaled hormones such as budesonide, it is mainly used for patients with suspected asthma who have obvious wheezing sounds. However, in reality, through my clinical practice observation, children who really suffer from asthma account for very few of all patients with wheezing. And our real clinical work tends to expand the scope of treatment of this drug. In addition, for β2 agonists such as salbutamol, terbutaline, formoterol, and procaterol, they are also mainly used in children with significant wheezing sounds in the lungs who are considered to have bronchospasm. In addition, according to reliable studies, the duration of application of such drugs should not exceed one week (week) in general, and if it exceeds one week, its efficacy is significantly reduced (drug tolerance) and side effects are prominent. At the same time, for small infants their efficacy is poor. However, in reality, most of them are used for cough suppression, and their efficacy is not obvious, nor is it an indication for the use of this type of drug. In addition, long-term inhalation of topical glucocorticoids such as budesonide can affect human immunity (decrease), height (decrease), sexual development (precocious puberty), etc.  Secondly, as a doctor, we should know that nebulizer inhalation therapy is only an adjuvant therapy, which is to treat the symptoms but not the root cause, and is often used only in the first 2-3 days of the disease (i.e., the early stage of the disease), and most of the diseases do not need to be used in the later stage of the disease process, which means that the use of nebulizer inhalation therapy in the later stage of the disease will not produce much efficacy, and increase the negative effects and the economic burden of the family. In addition, because it is only an adjuvant therapy, symptomatic therapy, the indicator does not cure the root cause, so the necessary antibacterial or antiviral (collectively called anti-infection) is necessary (because in reality, most wheezing diseases in children, are induced by infection). In other words, do not rely on nebulizer inhalation therapy, otherwise the condition will be delayed, making the condition persist, or even worsen, aggravate, and finally have to be hospitalized. As a parent, it is also important to know the above reasoning. Although nebulizer inhalation therapy is convenient, without injections, medication, but it has certain limitations, not a panacea, or abuse will delay the disease, leading to a decline in the body’s immunity, (sexual) precocious, obesity and other serious consequences, when it is too late to regret.