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Prerequisites for a dry powder inhaler for children with cystic fibrosis
- Source :
- PLoS ONE, PLoS ONE, 12(8):e0183130. PUBLIC LIBRARY SCIENCE, PLoS ONE, Vol 12, Iss 8, p e0183130 (2017)
- Publication Year :
- 2017
- Publisher :
- Public Library of Science, 2017.
-
Abstract
- Correct inhalation technique is essential for effective use of dry powder inhalers (DPIs), as their effectiveness largely depends on the patient's inhalation manoeuvre. Children are an especially challenging target population for DPI development due to the large variability in understanding and inspiratory capacities. We previously performed a study in which we determined the prerequisites for a paediatric DPI in a mostly healthy paediatric population, for which we used an empty test inhaler with variable internal airflow resistance and mouthpiece. In the current study we investigated what specifications are required for a DPI for children with cystic fibrosis (CF), for which we expanded on our previous findings. We recorded flow profiles of 35 children with CF (aged 4.7-14.7 years) at three airflow resistances (0.031-0.045 kPa0.5.min.L-1) from which various inspiratory parameters were computed. Obstructions in the mouth during inhalation were recorded with a sinuscope. All children were able to perform a correct inhalation manoeuvre, although video analysis showed that children did not place the inhaler correctly in the mouth in 17% of the cases. No effect was found of medium to high airflow resistance on total inhaled volume, which implies that the whole resistance range tested is suitable for children with CF aged 4-14 years. No effect could be established of either mouthpiece design or airflow resistance on the occurrence of obstructions in the mouth cavity. This study confirms our previous conclusion that the development of DPIs specifically for children is highly desired. Such a paediatric DPI should function well at 0.5 L inhaled volume and a peak inspiratory flow rate of 20 to 30 L/min, depending on the internal airflow resistance. This resistance can be increased up to 0.045 kPa0.5.min.L-1 (medium-high) to reduce oropharyngeal deposition. A higher resistance may be less favourable due to its compromising effect on PIF and thereby on the energy available for powder dispersion.
- Subjects :
- Male
Cystic Fibrosis
Pulmonology
Physiology
lcsh:Medicine
030226 pharmacology & pharmacy
Pediatrics
0302 clinical medicine
Medicine and Health Sciences
Public and Occupational Health
lcsh:Science
Child
Flow Rate
Multidisciplinary
medicine.diagnostic_test
Inhalation
Respiration
Physics
Child Health
AEROSOL
Classical Mechanics
Dry Powder Inhalers
Peak Inspiratory Flow Rate
Equipment Design
Dry-powder inhaler
Genetic Diseases
Anesthesia
Child, Preschool
Physical Sciences
Female
Powders
Anatomy
Research Article
Spirometry
medicine.medical_specialty
Adolescent
Materials by Structure
Airflow
Materials Science
Fluid Mechanics
Continuum Mechanics
03 medical and health sciences
Autosomal Recessive Diseases
Administration, Inhalation
medicine
Humans
Mouthpiece
Asthma
Clinical Genetics
Aerosols
Mouth
business.industry
Inhaler
lcsh:R
Biology and Life Sciences
Fluid Dynamics
medicine.disease
Fibrosis
Surgery
030228 respiratory system
LUNG DEPOSITION
Mixtures
ASTHMA
lcsh:Q
business
Physiological Processes
Digestive System
Developmental Biology
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 12
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....d89fcf93323aacc1f525c17e615b5d5b