Haidl Peter, Heindl Stefan, Siemon Karsten, Bernacka Maria, Cloes Rolf Michael
Hospital Kloster Grafschaft, Germany.
Bahnhofstraße 22, 82131 Gauting, Germany.
Respir Med. 2016 Sep;118:65-75. doi: 10.1016/j.rmed.2016.07.013. Epub 2016 Jul 21.
Inhaled drugs are the mainstay of treatment for lung diseases such as asthma and chronic obstructive pulmonary disease. However, failure to use inhalation devices correctly can lead to a poorly controlled status. A vast number of inhalation devices exist and each device has specific requirements to achieve optimum inhalation of the drug. Currently, there is no overview of inhalation requirements considering all devices. This article presents a review of the literature on different inhalation device requirements and incorporates the data into a new inhalation flow algorithm.
Data from literature on commercially available inhalation devices were evaluated and parameters, such as inhalation flow rate, flow acceleration, inhalation volume, and inspiration time assessed for the required inhalation maneuver specific to the device. All agreed upon data points were used to develop an inhalation flow algorithm.
The literature analysis revealed availability of robust data for the required inhalation flow characteristics for most devices and thus for the development of an algorithm. For those devices for which these parameters are not published, the minimum required flow criteria were defined based on published data regarding individual aspects of aerosol quality.
This review provides an overview of inhalation devices available on the market regarding requirements for an acceptable inhalation maneuver and shows which goals should be achieved in terms of inhalation flows. The presented algorithm can be used to develop a new computer based measurement system which could help to test and train patients' individual inhalation maneuvers with their inhalation devices.
吸入药物是哮喘和慢性阻塞性肺疾病等肺部疾病治疗的主要手段。然而,不正确使用吸入装置会导致病情控制不佳。市面上存在大量的吸入装置,每种装置都有实现药物最佳吸入的特定要求。目前,尚无考虑所有装置的吸入要求综述。本文对不同吸入装置要求的文献进行了综述,并将数据纳入一种新的吸入流量算法。
对市售吸入装置的文献数据进行评估,并针对该装置特定的所需吸入动作评估吸入流速、流量加速度、吸入量和吸气时间等参数。所有一致的数据点都用于开发一种吸入流量算法。
文献分析表明,大多数装置所需的吸入流量特性有可靠数据,因此可用于开发算法。对于未公布这些参数的装置,根据已公布的关于气溶胶质量各个方面的数据定义了所需的最低流量标准。
本综述概述了市场上现有吸入装置关于可接受吸入动作的要求,并表明在吸入流量方面应实现哪些目标。所提出的算法可用于开发一种新的基于计算机的测量系统,该系统有助于测试和训练患者使用其吸入装置的个体吸入动作。