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To the Editor:—
Nebulized bronchodilators and steam are useful to provide effective bronchial hygiene in many patients with chronic obstructive lung disease (emphysema and chronic bronchitis). The bronchodilator drug is indicated to combat bronchial mucosal edema and smooth muscle spasm (bronchospasm). Inhalation of steam helps moisturize and thin secretions to provide ease in removal by coughing or in-bed postural drainage maneuvers. This type of sequential therapeutic program is the mainstay of home management for many patients with marked airway resistance caused both by bronchospasm and by retained secretions.The available equipment designed to power nebulizers (pump and intermittent positive pressure respirator [IPPR] and humidifiers is excellent in design, but expensive. Simple hand bulb nebulizers require the patient's coordination and some degree of strength; sufficient hand strength is lacking in many patients who are chronically ill, and pain is a problem in patients with inflammatory arthritis.The adaptation of a tire
Petty TL, Nett LM. Home Inhalation Equipment For Less Than $10. JAMA. 1966;196(11):1027. doi:10.1001/jama.1966.03100240161056