Patient Inspiratory Maneuver Performance; Peak Lungpower, Acceleration and Volume

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Haikarainen , J , Vahteristo , M , Lahelma , S , Vartiainen , V & Malmberg , L P 2020 , ' Patient Inspiratory Maneuver Performance; Peak Lungpower, Acceleration and Volume ' , Journal of Aerosol Medicine and Pulmonary Drug Delivery , vol. 33 , no. 6 , pp. 305-313 .

Title: Patient Inspiratory Maneuver Performance; Peak Lungpower, Acceleration and Volume
Author: Haikarainen, Jussi; Vahteristo, Mikko; Lahelma, Satu; Vartiainen, Ville; Malmberg, Leo Pekka
Contributor organization: HUS Inflammation Center
Department of Dermatology, Allergology and Venereology
University of Helsinki
Helsinki University Hospital Area
Date: 2020-12-01
Language: eng
Number of pages: 9
Belongs to series: Journal of Aerosol Medicine and Pulmonary Drug Delivery
ISSN: 1941-2711
Abstract: Background: Use of drug delivery devices between nebulizers, dry powder inhalers (DPIs), or metered dose inhalers (MDIs), for treating patients with asthma and chronic obstructive pulmonary disease (COPD), is based on patients' capability of coordinating the inhalation maneuver and achieving sufficient airflow. There are limited data available with regard to how patients meet the requirements of successful inhalation performance, and how the concept of inspiratory lungpower could be applied. The aim of this work was to study the patient inspiratory airflow profile performance in large data sets. We analyzed how the Kamin-Haidl inhalation criteria were met by patients with DPIs such as Easyhaler for combination therapy (EH-combi), Easyhaler for monotherapy (EH-mono), Diskus, and Turbuhaler (TH), and applied peak lungpower instead of peak inspiratory flow rate as an indicator of patient performance. Materials and Methods: Data sets gathered in two previous studies for DPIs, that is, EH-combi, EH-mono, Diskus, and TH, were used to analyze how inspiratory lungpower representing inspiratory muscle power, flow acceleration, and volume after peak met the inhalation criteria. The measured patient airflow profiles through inhalers were assessed for patients with asthma or COPD. Results: Based on the Kamin-Haidl inhalation criteria, successful inhalation requirements were met with EH-combi in 96.1% and with EH-mono in 92.6% of patients. The success rates were 89.5% and 84.6% with Diskus and TH, respectively, (p <0.0001 between devices). In patients with asthma or COPD, the mean lungpower was 7.51 and 6.15 W for EH-combi, 8.79 and 6.88 W for EH-mono, 7.18 and 4.36 W for Diskus, and 9.65 and 6.86 W for TH, respectively, when patients followed the manufacturer's written instructions. Conclusions: Lungpower applied to the Kamin-Haidl inhalation criteria concept could be an applicable method for reviewing patient performance for different DPIs despite DPIs' characteristic differences in airflow resistance. In light of these results, DPIs provide a feasible treatment option for a large majority of respiratory patients.
Subject: airflow
airflow resistance
dry powder inhalers
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion

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