[The evaluation of useful breath actuated inhalers by preschool asthmatic children]

Area of Science:

• Pediatric Pulmonology
• Respiratory Medicine
• Asthma Management

Background:

• Clinical efficacy of breath-actuated inhalers is contingent upon achieving a sufficient Peak Inspiratory Flow (PIF).
• Current guidelines often restrict the use of these devices to older children due to PIF requirements.
• Preschool-aged children with stable asthma represent an understudied population regarding inhaler device usability.

Purpose of the Study:

• To evaluate the capability of preschool-aged children with stable asthma to effectively use breath-actuated inhalers.
• To compare the Peak Inspiratory Flow Rate (PIFR) achieved with different dry powder inhaler devices in this pediatric population.

Main Methods:

• A cohort of 156 preschool children (mean age 4.5 years) with stable asthma participated.
• Peak Inspiratory Flow Rate (PIFR) was measured using the In Check device with specific resistance valves for Turbuhaler, Diskus, and Easi Breathe.
• Statistical analysis was performed to compare PIFR across devices and assess correlations with age.

Main Results:

• The Easi Breathe device showed a significantly higher rate of minimal effective PIFR (98.1%) compared to Diskus (78.2%) and Turbuhaler (71.8%) (p < 0.05).
• A significant positive correlation was observed between PIFR and the age of the children for all tested devices.
• Most preschool asthmatic children in the stable phase could effectively use the Easi Breathe device.

Conclusions:

• Breath-actuated inhaler devices, particularly the Easi Breathe, show promise for effective use in preschool children with stable asthma.
• Assessment of Peak Inspiratory Flow Rate (PIFR) using the In Check device is recommended prior to initiating dry powder inhaler therapy in this age group.
• Age is a significant factor influencing the ability of young children to achieve adequate PIFR for inhaler use.