| Inappropriate Peak Inspiratory Flow Rate in the Patients with Stable Chronic Obstructive Pulmonary Disease in Korea |
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Seong Hwan Youn, MD, Hyun Jung Kim, MD, PhD, Jae Seok Park, MD, Sun Hyo Park, MD, PhD, Yong Shik Kwon, MD, Mi-Ae Kim, MD |
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Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Keimyung University School of Medicine, Dongsan Hospital, Daegu, south Korea |
Correspondence:
Hyun Jung Kim,
Email: khj82827@gmail.com
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Received: 20 December 2023 • Revised: 13 March 2024 • Accepted: 23 April 2024 |
| Abstract |
Background
Inhalation therapy efficacy hinges on proper peak inspiratory flow rate (PIFR) attainment, yet the prevalence of inappropriate PIFR among patients with chronic obstructive pulmonary disease (COPD) remains unstudied in Korea. This study aimed to assess the prevalence of inappropriate PIFR, its correlation with COPD assessment test (CAT) scores, and factors associated with suboptimal PIFR.
Methods
We enrolled 108 patients with COPD who had been using the same inhaler for at least one year without exacerbations. PIFR was measured using an inspiratory flow meter (In-Check™ DIAL G16). Demographic, clinical, pulmonary function, and CAT score data were collected. Inappropriate was defined as PIFR < 60L/min for dry power inhaler (DPI) users or > 90L/min for aerosol device users.
Results
The cohort comprised 87 (80.6%) men, mean age 71.0 ± 8.5 years, with mean post-bronchodilator forced expiratory volume in one second of 69.1 ± 1.8% predicted. Twenty-nine (26.9%) used aerosol devices, 76 (70.4%) used DPIs, and three (2.8%) used both. Inappropriate PIFRs were found in 17.2% of aerosol device users and 42.1% of DPI users. CAT scores were significantly higher in inappropriate PIFR group than appropriate PIFR group (11.2 ± 7.7 vs 7.5 ± 4.9, P = 0.003). In DPI users, female, shorter height, lower body weight and MVV (maximal voluntary ventilation) were associated with inappropriate PIFR.
Conclusions
Prevalence of inappropriate PIFR among patients with COPD is 17.2% for aerosol device users and 42.1% for DPI users. Suboptimal PIFR correlates with female gender, shorter stature, lower weight and MVV in DPI users. |
| Key Words:
Inspiratory flow, DPI, COPD, In-check dial, Inhaler, Peak inspiratory flow rate |
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