[Peak inspiratory flow using 2 different inhalers and a new portable device]

Area of Science:

• Pediatric pulmonology
• Respiratory device engineering

Background:

• Dry powder inhaler (DPI) use in children is common, but data on age-appropriateness is limited.
• Understanding peak inspiratory flow (PIF) is crucial for effective DPI use in pediatric populations.

Purpose of the Study:

• To compare PIF through Accuhaler and Turbuhaler devices in healthy children.
• To evaluate the utility of the In-check device in assessing pediatric inhaler technique.
• To determine differences between In-check and In-check Dial models.

Main Methods:

• PIF was measured in 64 healthy boys (mean age 11.2 years) using the In-check device with Accuhaler and Turbuhaler resistances.
• The best of three attempts was recorded.
• Height, weight, and forced expiratory volume in 1 second (FEV1) were also measured.

Main Results:

• Accuhaler consistently yielded significantly higher PIF than Turbuhaler across both In-check (134.4 vs 99.9 L/min) and In-check Dial (109.6 vs 86.8 L/min) measurements (p<0.000).
• Correlations between In-check measurements were strong (r=0.88 for Accuhaler vs Turbuhaler).
• PIF in children aged 9-14 years was sufficient for adequate medication delivery with both devices.

Conclusions:

• Accuhaler facilitates higher PIF than Turbuhaler in children aged 9-14.
• The In-check device can aid in determining a child's ability to use Turbuhaler effectively.
• Further assessment with In-check is recommended for children under 9, particularly during asthma exacerbations.