Assessment of the peak inspiratory flow rate of elderly chronic obstructive pulmonary disease patients through a turbuhaler

Abstract EN

Objectives : To assess the peak inspiratory flow rate of elderly chronic obstructive pulmonary disease patients through a Turbuhaler, and to determine whether these patients can inhale at the desired rate.

Method: Elderly stabilized in-patients with chronic obstructive pulmonary disease who were admitted to Leeds General Infirmary Chest and Respiratory Department between August 1998 and April 1999 were recruited in the study.

A Turbuhaler Trainer was used to determine the Peak Inspiratory Flow Rate (PIFR) of elderly chronic obstructive pulmonary disease patients when they used a Turbuhaler.

Spirometry and peak inspiratory flow rate were also measured using the In- Check meter.

Results: Seventy four chronic obstructive pulmonary disease patients with a mean age (SD) of 80 (8.4) years and % predicted of the Peak Expiratory Flow Rate of SO (17%), completed the study.

Using a normal inhalation technique, 14 patients achieved a PIFR with the Turbuhaler trainer of < 30L/min, 31 patients between 30-40 L/min, 23 patients achieved 40-60L / min and only 6 patients achieved > 60L/min.

Their PIFR ranges using the In-Check meter for these inhalation rate categories were 50-70, 50-130, 60-200 and 200- 250Umin, respectively.

After counseling on how to use the Turbuhaler trainer, 7patients achieved < 30Umin, 16 patients between 30-40L/min, 41 patients from 40- 60L/min and 10 patients achieved a PIFR > 60Umin.

The In-Check peak inspiratory flow rate ranges were 50-60, 50-130, 60-200 and 200-270L/min, respectively.

Conclusion: The Turbuhaler is a high resistance inspiratory flow device and thus only 8 % and 13.5 % of elderly chronic obstructive pulmonary disease patients before and after counseling respectively could inhale with an inspiratory rate of > 60Umin through the Turbuhaler.

Only those with an In-Check PIFR > 200L/min could inhale using the optimum rate for the Turbuhaler.

The In-Check meter could be useful to predict those who can effectively inhale through a turbuhaler.