title: Evaluation of the Target Inhalation Mode (TIM) breathing maneuver in simulated nebulizer therapy in patients with cystic fibrosis.
abstract: BACKGROUND
  Adaptive Aerosol Delivery (AAD) systems provide efficient drug delivery and improved lung deposition over conventional nebulizers by combining real-time analyses of patient breathing patterns and precisely timed aerosol delivery. Delivery and deposition are further enhanced by breathing techniques involving slow, deep inhalations.
  
  
  METHODS
  This exploratory study assessed the acceptability of slow, deep inhalations in 20 patients with cystic fibrosis (CF) during up to eight simulated nebulizer treatments with the I-neb AAD System. The breathing maneuver, Target Inhalation Mode (TIM) breathing, involved the lengthening of the patient's inhalation time over successive breaths with guidance from auditory and tactile (vibratory) feedback from the device.
  
  
  RESULTS
  At the end of the first treatment, most patients felt that the instructions were easy to understand (90%) and that the vibratory feedback was pleasant (65%). Half of the patients found the procedure to be comfortable. At the end of the final treatment, most patients felt that the breathing maneuver was easy to understand (90%) and use (80%), but that the duration of the breath was too long (100%). Logged data revealed that 90% of patients were able to comply with the breathing maneuver. The two patients unable to comply had a forced vital capacity of <1.75 L. The average treatment time decreased from 288.4 to 141.6 sec during the first and final treatments, respectively.
  
  
  CONCLUSIONS
  This study provides preliminary evidence of the acceptability of the TIM breathing maneuver in patients with CF and their ability to perform repeated TIM breathing during simulated nebulizer therapy with the I-neb AAD System.
authors.affiliation: Philips Respironics, Respiratory Drug Delivery Ltd, Chichester, United Kingdom. john.denyer@philips.com
authors.forename: John
authors.initials: J
authors.lastname: Denyer
authors.forename: Ivan
authors.initials: I
authors.lastname: Prince
authors.forename: Emma
authors.initials: E
authors.lastname: Dixon
authors.forename: Penny
authors.initials: P
authors.lastname: Agent
authors.forename: Jennifer
authors.initials: J
authors.lastname: Pryor
authors.forename: Margaret
authors.initials: M
authors.lastname: Hodson
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000336:Aerosols; D003550:Cystic Fibrosis / Q000188:drug therapy; D016503:Drug Delivery Systems / Q000295:instrumentation*; D005246:Feedback; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D010342:Patient Acceptance of Health Care; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D015656:Respiratory Mechanics; D013678:Technology, Pharmaceutical / Q000295:instrumentation; D013997:Time Factors; D055815:Young Adult
chemical_list: D000336:Aerosols; D004364:Pharmaceutical Preparations