Lung Deposition and Inspiratory Flow Rate in Patients with Chronic Obstructive Pulmonary Disease Using Different Inhalation Devices: A Systematic Literature Review and Expert Opinion

Background: Our aim was to describe: 1) lung deposition and inspiratory flow rate; 2) main characteristics of inhaler devices in chronic obstructive pulmonary disease (COPD). Methods: A systematic literature review (SLR) was conducted to analyze the features and results of inhaler devices in COPD pa...

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Autores: Baloira, Adolfo, Abad, Araceli, Fuster Gomila, Antonia, Garcia Rivero, Juan Luis, Garcia-Sidro, Patricia, Marquez-Martin, Eduardo, Palop, Marta, Soler, Nestor, Velasco, JL, Gonzalez-Torralba, Fernando
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/23165
Acceso en línea:https://hdl.handle.net/20.500.12105/23165
Access Level:acceso abierto
Palabra clave:COPD
Lung deposition
Inspiratory flow
Inhalation devices
Systematic literature review
Testimonio de Experto
Enfermedad Pulmonar Obstructiva Crónica
Broncodilatadores
Humanos
Diseño de Equipo
Pulmón
Inhaladores de Dosis Medida
Administración por Inhalación
Inhaladores de Polvo Seco
Lung
Dry Powder Inhalers
Equipment Design
Administration, Inhalation
Pulmonary Disease, Chronic Obstructive
Expert Testimony
Humans
Bronchodilator Agents
Metered Dose Inhalers
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spelling Lung Deposition and Inspiratory Flow Rate in Patients with Chronic Obstructive Pulmonary Disease Using Different Inhalation Devices: A Systematic Literature Review and Expert OpinionBaloira, AdolfoAbad, AraceliFuster Gomila, AntoniaGarcia Rivero, Juan LuisGarcia-Sidro, PatriciaMarquez-Martin, EduardoPalop, MartaSoler, NestorVelasco, JLGonzalez-Torralba, FernandoCOPDLung depositionInspiratory flowInhalation devicesSystematic literature reviewTestimonio de ExpertoEnfermedad Pulmonar Obstructiva CrónicaBroncodilatadoresHumanosDiseño de EquipoPulmónInhaladores de Dosis MedidaAdministración por InhalaciónInhaladores de Polvo SecoLungDry Powder InhalersEquipment DesignAdministration, InhalationPulmonary Disease, Chronic ObstructiveExpert TestimonyHumansBronchodilator AgentsMetered Dose InhalersBackground: Our aim was to describe: 1) lung deposition and inspiratory flow rate; 2) main characteristics of inhaler devices in chronic obstructive pulmonary disease (COPD). Methods: A systematic literature review (SLR) was conducted to analyze the features and results of inhaler devices in COPD patients. These devices included pressurized metered-dose inhalers (pMDIs), dry powder inhalers (DPIs), and a soft mist inhaler (SMI). Inclusion and exclusion criteria were established, as well as search strategies (Medline, Embase, and the Cochrane Library up to April 2019). In vitro and in vivo studies were included. Two reviewers selected research articles, collected and analyzed data independently. Narrative searches complemented the SLR. We discussed the results of the reviews in a nominal group meeting and agreed on various general principles and recommendations. Results: The SLR included 71 research articles, some were of low-moderate quality, and there was great variability regarding populations and outcomes. Lung deposition rates varied across devices: 8%-53% for pMDIs, 7%-69% for DPIs, and 39%-67% for the SMI. The aerosol exit velocity was high with pMDIs (more than 3 m/s), while it is much slower (0.84-0.72 m/s) with the SMI. In general, pMDIs produce large-sized presearch articles (1.22-8 mu m), DPIs produce medium-sized presearch articles (1.8-4.8 mu m), and 60% of the presearch articles reach an aerodynamic diameter <5 mu m with the SMI. All inhalation devices reach central and peripheral lung regions, but the SMI distribution pattern might be better compared with pMDIs. DPIs' intrinsic resistance is higher than that of pMDIs and SMI, which are relatively similar and low. Depending on the DPI, the minimum flow inspiratory rate required was 30 L/min. pMDIs and SMI did not require a high inspiratory flow rate. Conclusion: Lung deposition and inspiratory flow rate are key factors when selecting an inhalation device in COPD patients.Dove Medical Press20242024-09-1820212021-01-0120212021-01-01review articlehttp://purl.org/coar/resource_type/c_dcae04bcinfo:eu-repo/semantics/articlehttps://hdl.handle.net/20.500.12105/23165reponame:Repisaludinstname:Instituto de Salud Carlos III (ISCIII)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:repisalud.isciii.es:20.500.12105/231652026-06-12T12:43:37Z
dc.title.none.fl_str_mv Lung Deposition and Inspiratory Flow Rate in Patients with Chronic Obstructive Pulmonary Disease Using Different Inhalation Devices: A Systematic Literature Review and Expert Opinion
title Lung Deposition and Inspiratory Flow Rate in Patients with Chronic Obstructive Pulmonary Disease Using Different Inhalation Devices: A Systematic Literature Review and Expert Opinion
spellingShingle Lung Deposition and Inspiratory Flow Rate in Patients with Chronic Obstructive Pulmonary Disease Using Different Inhalation Devices: A Systematic Literature Review and Expert Opinion
Baloira, Adolfo
COPD
Lung deposition
Inspiratory flow
Inhalation devices
Systematic literature review
Testimonio de Experto
Enfermedad Pulmonar Obstructiva Crónica
Broncodilatadores
Humanos
Diseño de Equipo
Pulmón
Inhaladores de Dosis Medida
Administración por Inhalación
Inhaladores de Polvo Seco
Lung
Dry Powder Inhalers
Equipment Design
Administration, Inhalation
Pulmonary Disease, Chronic Obstructive
Expert Testimony
Humans
Bronchodilator Agents
Metered Dose Inhalers
title_short Lung Deposition and Inspiratory Flow Rate in Patients with Chronic Obstructive Pulmonary Disease Using Different Inhalation Devices: A Systematic Literature Review and Expert Opinion
title_full Lung Deposition and Inspiratory Flow Rate in Patients with Chronic Obstructive Pulmonary Disease Using Different Inhalation Devices: A Systematic Literature Review and Expert Opinion
title_fullStr Lung Deposition and Inspiratory Flow Rate in Patients with Chronic Obstructive Pulmonary Disease Using Different Inhalation Devices: A Systematic Literature Review and Expert Opinion
title_full_unstemmed Lung Deposition and Inspiratory Flow Rate in Patients with Chronic Obstructive Pulmonary Disease Using Different Inhalation Devices: A Systematic Literature Review and Expert Opinion
title_sort Lung Deposition and Inspiratory Flow Rate in Patients with Chronic Obstructive Pulmonary Disease Using Different Inhalation Devices: A Systematic Literature Review and Expert Opinion
dc.creator.none.fl_str_mv Baloira, Adolfo
Abad, Araceli
Fuster Gomila, Antonia
Garcia Rivero, Juan Luis
Garcia-Sidro, Patricia
Marquez-Martin, Eduardo
Palop, Marta
Soler, Nestor
Velasco, JL
Gonzalez-Torralba, Fernando
author Baloira, Adolfo
author_facet Baloira, Adolfo
Abad, Araceli
Fuster Gomila, Antonia
Garcia Rivero, Juan Luis
Garcia-Sidro, Patricia
Marquez-Martin, Eduardo
Palop, Marta
Soler, Nestor
Velasco, JL
Gonzalez-Torralba, Fernando
author_role author
author2 Abad, Araceli
Fuster Gomila, Antonia
Garcia Rivero, Juan Luis
Garcia-Sidro, Patricia
Marquez-Martin, Eduardo
Palop, Marta
Soler, Nestor
Velasco, JL
Gonzalez-Torralba, Fernando
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv COPD
Lung deposition
Inspiratory flow
Inhalation devices
Systematic literature review
Testimonio de Experto
Enfermedad Pulmonar Obstructiva Crónica
Broncodilatadores
Humanos
Diseño de Equipo
Pulmón
Inhaladores de Dosis Medida
Administración por Inhalación
Inhaladores de Polvo Seco
Lung
Dry Powder Inhalers
Equipment Design
Administration, Inhalation
Pulmonary Disease, Chronic Obstructive
Expert Testimony
Humans
Bronchodilator Agents
Metered Dose Inhalers
topic COPD
Lung deposition
Inspiratory flow
Inhalation devices
Systematic literature review
Testimonio de Experto
Enfermedad Pulmonar Obstructiva Crónica
Broncodilatadores
Humanos
Diseño de Equipo
Pulmón
Inhaladores de Dosis Medida
Administración por Inhalación
Inhaladores de Polvo Seco
Lung
Dry Powder Inhalers
Equipment Design
Administration, Inhalation
Pulmonary Disease, Chronic Obstructive
Expert Testimony
Humans
Bronchodilator Agents
Metered Dose Inhalers
description Background: Our aim was to describe: 1) lung deposition and inspiratory flow rate; 2) main characteristics of inhaler devices in chronic obstructive pulmonary disease (COPD). Methods: A systematic literature review (SLR) was conducted to analyze the features and results of inhaler devices in COPD patients. These devices included pressurized metered-dose inhalers (pMDIs), dry powder inhalers (DPIs), and a soft mist inhaler (SMI). Inclusion and exclusion criteria were established, as well as search strategies (Medline, Embase, and the Cochrane Library up to April 2019). In vitro and in vivo studies were included. Two reviewers selected research articles, collected and analyzed data independently. Narrative searches complemented the SLR. We discussed the results of the reviews in a nominal group meeting and agreed on various general principles and recommendations. Results: The SLR included 71 research articles, some were of low-moderate quality, and there was great variability regarding populations and outcomes. Lung deposition rates varied across devices: 8%-53% for pMDIs, 7%-69% for DPIs, and 39%-67% for the SMI. The aerosol exit velocity was high with pMDIs (more than 3 m/s), while it is much slower (0.84-0.72 m/s) with the SMI. In general, pMDIs produce large-sized presearch articles (1.22-8 mu m), DPIs produce medium-sized presearch articles (1.8-4.8 mu m), and 60% of the presearch articles reach an aerodynamic diameter <5 mu m with the SMI. All inhalation devices reach central and peripheral lung regions, but the SMI distribution pattern might be better compared with pMDIs. DPIs' intrinsic resistance is higher than that of pMDIs and SMI, which are relatively similar and low. Depending on the DPI, the minimum flow inspiratory rate required was 30 L/min. pMDIs and SMI did not require a high inspiratory flow rate. Conclusion: Lung deposition and inspiratory flow rate are key factors when selecting an inhalation device in COPD patients.
publishDate 2021
dc.date.none.fl_str_mv 2021
2021-01-01
2021
2021-01-01
2024
2024-09-18
dc.type.none.fl_str_mv review article
http://purl.org/coar/resource_type/c_dcae04bc
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.12105/23165
url https://hdl.handle.net/20.500.12105/23165
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Dove Medical Press
publisher.none.fl_str_mv Dove Medical Press
dc.source.none.fl_str_mv reponame:Repisalud
instname:Instituto de Salud Carlos III (ISCIII)
instname_str Instituto de Salud Carlos III (ISCIII)
reponame_str Repisalud
collection Repisalud
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.811543

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