Sensitivity of Turbutester and Accuhaler tester in asthmatic children and adolescents.
BACKGROUND
Dry powder inhalers (DPI) are alternative devices for delivering medication for treatment of asthma. The amount of drug delivery to the lungs is directly influenced by peak inspiratory flow rate (PIFR). A minimum PIFR of -30 L/min is needed for the Turbuhaler and Accuhaler.


METHODS
In order to evaluate the sensitivity of the Turbutester and Accuhaler tester in detecting the minimum and optimum PIFR for the Turbuhaler and Accuhaler in asthmatic children, PIFR was measured using the In-Check Dial through the internal resistance of the Turbuhaler and Accuhaler and compared according to the child's ability to make a whistle sound via both testers.


RESULTS
A total of 259 asthmatic children were studied: 20 pre-school children, aged 5-6 years; 174 school-age children, aged 7-12 years; and 65 adolescents, aged 13-18 years. The sensitivity of the Turbutester and Accuhaler tester to detect optimum PIFR were 98.40% and 97.2%, respectively. In the comparison among age groups, the sensitivity of the Accuhaler tester to detect optimum or minimum PIFR for the Accuhaler was 95%, 97.7% and 95.4%, respectively. The sensitivity of the Turbutester to detect optimum PIFR for the Turbuhaler was 94.4%, 98.8% and 98.5%, respectively. The sensitivity of the Turbutester to detect minimum PIFR for the Turbuhaler was 94.7%, 100% and 100%, respectively. There were no significant differences in percentage of having optimum or minimum PIFR among asthma severity and current device usage in all age groups.


CONCLUSIONS
Most children aged at least 5 years could generate enough PIFR to use dry powder inhaler devices. Both the Turbutester and Accuhaler tester were found to have high sensitivity in detecting optimum and minimum required PIFR.
Manuyakorn
Wiparat
W
Division of Allergy and Immunology, Department of Pediatrics, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand. rawmy@mahidol.ac.th
Direkwattanachai
Chalerat
C
Benjaponpitak
Suwat
S
Kamchaisatian
Wasu
W
Sasisakulporn
Cherapat
C
Teawsomboonkit
Wanlapa
W
D000293:Adolescent; D000367:Age Factors; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy*; D001827:Body Height; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D006801:Humans; D007320:Inspiratory Capacity; D008176:Lung Volume Measurements / Q000295:instrumentation*; D008297:Male; D009330:Nebulizers and Vaporizers; D012680:Sensitivity and Specificity
D018927:Anti-Asthmatic Agents