Publication

Prerequisites for a dry powder inhaler for children with cystic fibrosis

Lexmond, A. J., Hagedoorn, P., Frijlink, H. W., Rottier, B. L. & de Boer, A. H. 11-Aug-2017 In : PLoS ONE. 12, 8, 13 p., e0183130

Research output: Scientific - peer-reviewArticle

APA

Lexmond, A. J., Hagedoorn, P., Frijlink, H. W., Rottier, B. L., & de Boer, A. H. (2017). Prerequisites for a dry powder inhaler for children with cystic fibrosis. PLoS ONE, 12(8), [e0183130]. DOI: 10.1371/journal.pone.0183130

Author

Lexmond, Anne J; Hagedoorn, Paul; Frijlink, Henderik W; Rottier, Bart L; de Boer, Anne H / Prerequisites for a dry powder inhaler for children with cystic fibrosis.

In: PLoS ONE, Vol. 12, No. 8, e0183130, 11.08.2017.

Research output: Scientific - peer-reviewArticle

Harvard

Lexmond, AJ, Hagedoorn, P, Frijlink, HW, Rottier, BL & de Boer, AH 2017, 'Prerequisites for a dry powder inhaler for children with cystic fibrosis' PLoS ONE, vol 12, no. 8, e0183130. DOI: 10.1371/journal.pone.0183130

Standard

Prerequisites for a dry powder inhaler for children with cystic fibrosis. / Lexmond, Anne J; Hagedoorn, Paul; Frijlink, Henderik W; Rottier, Bart L; de Boer, Anne H.

In: PLoS ONE, Vol. 12, No. 8, e0183130, 11.08.2017.

Research output: Scientific - peer-reviewArticle

Vancouver

Lexmond AJ, Hagedoorn P, Frijlink HW, Rottier BL, de Boer AH. Prerequisites for a dry powder inhaler for children with cystic fibrosis. PLoS ONE. 2017 Aug 11;12(8). e0183130. Available from, DOI: 10.1371/journal.pone.0183130


BibTeX

@article{f79795a691014f79a833783fa0345f32,
title = "Prerequisites for a dry powder inhaler for children with cystic fibrosis",
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.",
keywords = "AEROSOL, ASTHMA, LUNG DEPOSITION, INHALATION",
author = "Lexmond, {Anne J} and Paul Hagedoorn and Frijlink, {Henderik W} and Rottier, {Bart L} and {de Boer}, {Anne H}",
year = "2017",
month = "8",
doi = "10.1371/journal.pone.0183130",
volume = "12",
journal = "PLoS ONE",
issn = "1932-6203",
publisher = "PUBLIC LIBRARY SCIENCE",
number = "8",

}

RIS

TY - JOUR

T1 - Prerequisites for a dry powder inhaler for children with cystic fibrosis

AU - Lexmond,Anne J

AU - Hagedoorn,Paul

AU - Frijlink,Henderik W

AU - Rottier,Bart L

AU - de Boer,Anne H

PY - 2017/8/11

Y1 - 2017/8/11

N2 - 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.

AB - 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.

KW - AEROSOL

KW - ASTHMA

KW - LUNG DEPOSITION

KW - INHALATION

U2 - 10.1371/journal.pone.0183130

DO - 10.1371/journal.pone.0183130

M3 - Article

VL - 12

JO - PLoS ONE

T2 - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 8

M1 - e0183130

ER -

ID: 47533378