Not the mean value of peak inspiratory flow (PIF), but the number of patients who are able to gain minimal and/or optimal peak inspiratory flow with resistence represented dry powder inhaler, is the proper measure of its utility

Source: Annual Congress 2001 - Monitoring acute lung disease

Session: Monitoring acute lung disease
Session type: Thematic Poster Session
Number: 1655

Disease area: Airway diseases

Abstract

In a number of publications inspiratory flow rates are described as minimal and optimal flow necessary for proper drug delivery from DPIs to the airways. The special requirements of any particular DPI depend on its total resistance and other features of its construction. Peak inspiratory flow measurement (PIF) with additional resistance represented particular DPI, was developed as a useful tool to support decision of the most appropriate device for any given patient ([dsquote]In-Check[dsquote], Clement-Clarke). Number of publications exist compering practical clinical utility of different DPIs on the base of mean values of the inspiratory flows with additional resistance represented devices studied. This approach does not take to accout an individual patient, what is reflected by high variability of the results in most cases. Patients as a group can achieve mean minimal and optimal flow needed, but on the other hand sagnifficant proportion of individuals can be below this border. In our study we wanted to show this important paradox by comparing mean PIF for the group of 120 adult asthmatic patients to the proportion of patients below minimal and optimal flows recommended for two popular on Polish market DPIs - Aerolizer® and Turbuhaler® (30L/min and 90L/min respectivly). [dsquote]In-Check[dsquote] kit was used. PIFR with additional valves which could mimic the internal resistance of mentioned DPIs was measured. Results - see tab. below. *Chi2 - p < 0,0001

		N(%) of patients below minimal recommended PIF		mean (SD) PIF (L/min)
Invest. group	N=	Aerolizer	Turbuhaler	Aerolizer	Turbuhaler
Women	70	41 (59)	12 (17)	82.8 (33.4)	44.4 (19.3)
Men	50	13 (26)	4 (16)	104.9 (33.9)	54.7 (18.3)
In total	120	54 (45)*	16 (13)*	92.0 (35.2)	48.7 (19.5)

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Citations should be made in the following way:
E. Florkiewicz (Sieradz, Poland). Not the mean value of peak inspiratory flow (PIF), but the number of patients who are able to gain minimal and/or optimal peak inspiratory flow with resistence represented dry powder inhaler, is the proper measure of its utility. Eur Respir J 2001; 16: Suppl. 31, 1655

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