Vibrating Mesh Nebulizers for Patients with Respiratory Conditions: Clinical Effectiveness, Cost-Effectiveness, and Guidelines

Key Message

Evidence of limited quality from three studies was identified on the comparative clinical effectiveness of vibrating mesh nebulizers for patients with respiratory conditions in acute care settings. In the findings presented in this report, vibrating mesh nebulizers were shown to be either more effective or not detectably different than metered-dose inhalers and jet nebulizers. One randomized controlled trial that enrolled a total of 72 patients found asthma patients treated with vibrating mesh nebulizers spent fewer days in intensive care than patients treated with metered-dose inhalers, but there were no differences between groups for days of mechanical ventilation. This RCT did not find any significant difference in the clinical effectiveness of vibrating mesh nebulizers and jet nebulizers for patients with asthma in the emergency department. A retrospective study of 228 patients did not observe statistically significant differences in effectiveness outcomes for vibrating mesh nebulizers compared to metered-dose inhalers. Another retrospective observational study identified that patients treated with vibrating mesh nebulizers experienced significantly lower total albuterol dose, more discharges from hospital, fewer admissions to hospital, and shorter emergency department length of stay compared to patients treated with jet nebulizers. Important context for all identified clinical effectiveness findings was lacking due to an absence of information on adverse event measurement or reporting. Future high-quality studies are required to make conclusions regarding the comparative clinical effectiveness and safety of vibrating mesh nebulizers. No cost-effectiveness evidence or relevant evidence-based guidelines were identified.