Less is More: Rethinking Routine Oxygen-Driven Nebulization

Abstract Traditional nebulization for acute wheeze across all ages, from children to adults, has been in clinical practice for decades. In recent times, oxygen-driven nebulization (ODN) has been recommended to reduce the risk of paradoxical hypoxia and mortality during treatment of acute wheeze. However, like any other drug, oxygen should be used judiciously. The routine use of ODN is neither cost-effective nor devoid of side effects, and the use of oxygen as a driving force for nebulization warrants reevaluation. Oxygen-blended nebulization is proposed as a more balanced and personalized alternative, integrating saturation monitoring and titration of supplemental oxygen based on individual needs for both children and adults in a hospital environment.