Peak inspiratory flow in children and adolescents with asthma using dry powder inhalers: a cross-sectional study

Silva, Caroline Palácio da; Cordeiro, Jean Silva Aretakis; Britto, Murilo Carlos Amorim de; Bezerra, Patrícia Gomes de Matos; Andrade, Lívia Barboza de

doi:10.36416/1806-3756/e20200473

Cited by 5 publications

(4 citation statements)

References 27 publications

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“…Patients without tracheostomy underwent preoperative lung functional tests (LFT) measuring peak tidal inspiratory flow (PTIF) 20 if less than 2 years old, and peak inspiratory flow (PIF) 21 if older. For further details, a sleep study (respiratory polygraphy) comparing the number of desaturations/hour (ODI/h), 22 and the Maximum phonation time (MPT) 23 was performed.…”

Section: Methodsmentioning

confidence: 99%

Pediatric Bilateral Vocal Cord Immobility: New Treatment With Preservation of Voice

et al. 2022

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ObjectivesPediatric bilateral vocal cord immobility (BVCI) represents a severe life‐threatening condition that often causes severe dyspnea. Endoscopic arytenoid lateral abduction (EALA) is a relatively new, secure, minimal‐invasive surgical technique. The present prospective observational study aims to evaluate the effects of EALA in terms of respiratory function, voice quality, and swallowing capabilities.MethodsTwenty‐one pediatric patients with BVCI underwent EALA. Eleven out of 21 patients had tracheostomy at the time of surgery. Pre and postoperative functional assessments included endoscopic evaluation, maximum phonation time, pediatric Voice Handicap Index (pVHI), GIRBAS Scale criteria, and Montreal Children's Hospital Feeding scale (MCH‐Feeding scale). peak tidal inspiratory flow or peak inspiratory flow (PIF) and number of desaturations/hour (ODI/h) were evaluated in patients without tracheostomy.ResultsPostoperative endoscopy showed glottic airway improvement in all patients. Average time for decannulation was 4.6 weeks. One patient has not yet been decannulated. No major complications occurred. In patients without tracheostomy, we observed a significant improvement of ODI/h and PIF after surgery (p < 0.05) as expected. PVHI, MCH‐Feeding scale, and GIRBAS score significantly worsened 1 month after surgical intervention (p < 0.05). One year after surgery, however, all values, except for B and A parameters of the GIRBAS score, returned to levels comparable to those preoperative.ConclusionsEALA represents a simple, safe and effective solution in pediatric patients with BVCI, avoiding tracheostomy, allowing early decannulation, preserving swallowing function, and maintaining good quality voice.Level of Evidence4 Laryngoscope, 133:2325–2332, 2023

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Section: Methodsmentioning

confidence: 99%

Pediatric Bilateral Vocal Cord Immobility: New Treatment With Preservation of Voice

et al. 2022

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“…Checking of asthma control is usually pursued by a combination of different tools, such as periodic reports of symptoms (such as by specific questionnaires such as the Asthma Control Test-ACT [6,7] or Childhood Asthma Control Test [8], the incidence of exacerbations, the count of rescue drugs used in a fixed period (i.e., daily, weekly, monthly); measures of markers of type-2 inflammation in the airways (namely, fractional exhaled nitric oxide-FeNO [9], and lung function tests (currently, peak flow measurements at home or laboratory forced expiratory volume in 1 s [FEV 1 ]) [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Trend of Bronchial Hyperresponsiveness to Methacholine as a Cost Predictor of Mild-to-Moderate Asthma: A Twelve-Month Survey in Teenagers

Dal Negro,

Turco,

Povero

2023

Children

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Bronchial asthma is characterized by variable airflow obstruction, airway inflammation, and bronchial hyperresponsiveness (BHR) to non-specific stimuli. The role of underlying airway inflammation and of related long-lasting BHR has been suboptimally investigated in teenagers with mild-to-moderate asthma, as has the corresponding economic impact over time. The aim of the present study was to calculate the cost of mild-to-moderate atopic asthma in teenagers arising from their degree of persisting BHR over a twelve-month period. Methods: Patients aged 12–18 years with mild-to-moderate symptoms treated with fluticasone fumarate/vilanterol 92/22 mcg daily were retrospectively followed for 12 months. Usual spirometric parameters, BHR to methacholine (MCh), and resource consumption (visits, hospitalizations, systemic steroids and/or antibiotics courses, school days off) were assessed at recruitment (the index date) and after 6 and 12 months. Adherence to treatment was also calculated. The cost of asthma was calculated based on Italian tariffs and published papers. The trend over time in BHR and the association between response to MCh and total cost were investigated by using regression models adjusted for repeated measures. Results: 106 teenagers (53 males, age 15.9 ± 1.6 years) were investigated. The annual cost of asthma proved significantly related to the BHR trend: every increment of a factor 10 in the response to MCh was associated with a saving of EUR 184.90 (95% CI −305.89 to −63.90). BHR was progressively optimized after 6 and 12 months in relation to the patients’ compliance to treatment (≥70% of prescribed inhalation doses). Conclusions: the usual spirometric parameters are largely insufficient to reflect the effects of underlying persistent inflammation in milder forms of asthma in teenagers. In terms of clinical governance, the periodic assessment of non-specific BHR is the appropriate procedure from this point of view. Non-specific BHR proves a reliable procedure for predicting and monitoring the economic impact of mild-to-moderate asthma in teenagers over time.

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“…[ 6 , 7 , 8 , 9 , 10 ] It was reported that the error rates of different devices ranged from 58.9% to 87.9%, while suboptimal PIFr was common in patients with asthma or COPD. [ 11 , 12 , 13 , 14 , 15 ] Critical errors in inhaler use, including lack of synchronization, expiration in powder device before inhalation, and remaining powder in the capsule by the end were associated with an increased rate of severe COPD exacerbation. [ 16 ] Also, a systematic review identified an association between inhaler errors and poor asthma control, COPD disease stability, and greater economic burden on health.…”

mentioning

confidence: 99%

“…[ 30 ] People with COPD and asthma tended to have lower PIFr than healthy people. [ 15 , 31 ] Also, participants with active asthma or COPD exacerbation showed a lower PIFr than those without an exacerbation. [ 7 ] Individuals with suboptimal PIFr were common among COPD patients hospitalized for acute exacerbations.…”

mentioning

confidence: 99%

Standardized inhalation capability assessment: A key to optimal inhaler selection for inhalation therapy

Zhang

2023

Journal of Translational Internal Medicine

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Inhalation therapy has become one of the fundamental treatments for chronic obstructive pulmonary disease (COPD) and bronchial asthma (asthma). [1,2] Meanwhile, with the development of inhaled formulations and devices, inhalation therapy has shown a wide prospect of expanding indications, including respiratory diseases such as lower respiratory tract infections, [3] interstitial lung diseases, lung cancer, [4] as well as other diseases such as diabetes and depression. [5] Compared to oral and intravenous administration, the aerosolized drug is inhaled and acts directly on the airways and lungs, which has the advantages of rapid onset, sustained efficacy, and low systemic adverse effects. [6] Compared to the nebulizer, the hand-held inhaler is a better option for out-of-hospital drug delivery because the latter is easier to operate, requires shorter inhalation time, and has less environment extravasation. [6] How to cite this article: Wu Y, Zhang J. Standardized inhalation capability assessment: A key to optimal inhaler selection for inhalation therapy. J Transl Intern Med 2023; AOP.

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Peak inspiratory flow in children and adolescents with asthma using dry powder inhalers: a cross-sectional study

Cited by 5 publications

References 27 publications

Pediatric Bilateral Vocal Cord Immobility: New Treatment With Preservation of Voice

Pediatric Bilateral Vocal Cord Immobility: New Treatment With Preservation of Voice

Trend of Bronchial Hyperresponsiveness to Methacholine as a Cost Predictor of Mild-to-Moderate Asthma: A Twelve-Month Survey in Teenagers

Standardized inhalation capability assessment: A key to optimal inhaler selection for inhalation therapy

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