Predictors of Suboptimal Peak Inspiratory Flow in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Clinical Practice
Background Incorrect inhalation technique is a primary cause of therapeutic failure in chronic obstructive pulmonary disease (COPD), leading to increased exacerbation frequency. Identifying predictors of suboptimal peak inspiratory flow (sPIF) can significantly enhance treatment efficacy in COPD pat...
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The Korean Academy of Tuberculosis and Respiratory Diseases
2025-07-01
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| Series: | Tuberculosis and Respiratory Diseases |
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| Online Access: | http://e-trd.org/upload/pdf/trd-2024-0154.pdf |
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| author | Natalia V. Trushenko Baina B. Lavginova Svetlana Yu. Chikina Natalia E. Obukhova Iuliia A. Levina Fedor D. Tkachenko Galina V. Nekludova Zamira M. Merzhoeva Sergey N. Avdeev |
| author_facet | Natalia V. Trushenko Baina B. Lavginova Svetlana Yu. Chikina Natalia E. Obukhova Iuliia A. Levina Fedor D. Tkachenko Galina V. Nekludova Zamira M. Merzhoeva Sergey N. Avdeev |
| author_sort | Natalia V. Trushenko |
| collection | DOAJ |
| description | Background Incorrect inhalation technique is a primary cause of therapeutic failure in chronic obstructive pulmonary disease (COPD), leading to increased exacerbation frequency. Identifying predictors of suboptimal peak inspiratory flow (sPIF) can significantly enhance treatment efficacy in COPD patients. The objective of this study was to identify the prevalence and predictors of sPIF in hospitalized patients with acute exacerbation of COPD in a clinical setting. Methods This study enrolled 72 patients hospitalized for acute COPD exacerbation. It analyzed demographic, clinical, and lung function parameters. Peak inspiratory flow (PIF) was measured using an In-Check DIAL G16 (Alliance Tech Medical) across different resistance levels of the patients’ inhalation devices, both before and after instruction in inhalation technique, and at various resistance settings (R2 and R5) upon admission and discharge. Results Initially, 52.7% of patients exhibited sPIF, which decreased to 19.4% following inhalation technique education (p<0.0001). Receiver operating curve analysis identified age >70 years, forced vital capacity <73% predicted (pred.), forced expiratory volume in 1 second (FEV1) <35% pred., residual volume (RV) >194% pred., RV/total lung capacity >70%, and diffusing capacity for carbon monoxide <36% pred. as independent predictors of sPIF. The most significant predictors were age (odds ratio [OR], 0.89) and FEV1 (OR 0.59). Conclusion Selecting a suitable dry powder inhaler for maintenance therapy in patients with acute exacerbation of COPD requires consideration of the patient's ability to achieve optimal PIF, with special attention to age and severity of functional impairment. |
| format | Article |
| id | doaj-art-aa4ec72b05354dcfb255bbdfd0ba777f |
| institution | DOAJ |
| issn | 1738-3536 2005-6184 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | The Korean Academy of Tuberculosis and Respiratory Diseases |
| record_format | Article |
| series | Tuberculosis and Respiratory Diseases |
| spelling | doaj-art-aa4ec72b05354dcfb255bbdfd0ba777f2025-08-20T02:43:39ZengThe Korean Academy of Tuberculosis and Respiratory DiseasesTuberculosis and Respiratory Diseases1738-35362005-61842025-07-0188351652510.4046/trd.2024.01544930Predictors of Suboptimal Peak Inspiratory Flow in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Clinical PracticeNatalia V. Trushenko0Baina B. Lavginova1Svetlana Yu. Chikina2Natalia E. Obukhova3Iuliia A. Levina4Fedor D. Tkachenko5Galina V. Nekludova6Zamira M. Merzhoeva7Sergey N. Avdeev8 Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Moscow, Russia Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Moscow, Russia Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Moscow, Russia Department of Otorhinolaryngology, Central State Medical Academy, Moscow, Russia Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Moscow, Russia Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Moscow, Russia Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Moscow, Russia Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Moscow, Russia Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Moscow, RussiaBackground Incorrect inhalation technique is a primary cause of therapeutic failure in chronic obstructive pulmonary disease (COPD), leading to increased exacerbation frequency. Identifying predictors of suboptimal peak inspiratory flow (sPIF) can significantly enhance treatment efficacy in COPD patients. The objective of this study was to identify the prevalence and predictors of sPIF in hospitalized patients with acute exacerbation of COPD in a clinical setting. Methods This study enrolled 72 patients hospitalized for acute COPD exacerbation. It analyzed demographic, clinical, and lung function parameters. Peak inspiratory flow (PIF) was measured using an In-Check DIAL G16 (Alliance Tech Medical) across different resistance levels of the patients’ inhalation devices, both before and after instruction in inhalation technique, and at various resistance settings (R2 and R5) upon admission and discharge. Results Initially, 52.7% of patients exhibited sPIF, which decreased to 19.4% following inhalation technique education (p<0.0001). Receiver operating curve analysis identified age >70 years, forced vital capacity <73% predicted (pred.), forced expiratory volume in 1 second (FEV1) <35% pred., residual volume (RV) >194% pred., RV/total lung capacity >70%, and diffusing capacity for carbon monoxide <36% pred. as independent predictors of sPIF. The most significant predictors were age (odds ratio [OR], 0.89) and FEV1 (OR 0.59). Conclusion Selecting a suitable dry powder inhaler for maintenance therapy in patients with acute exacerbation of COPD requires consideration of the patient's ability to achieve optimal PIF, with special attention to age and severity of functional impairment.http://e-trd.org/upload/pdf/trd-2024-0154.pdfchronic obstructive pulmonary diseaseexacerbationpeak inspiratory flowdry powder inhalerinhalation technique |
| spellingShingle | Natalia V. Trushenko Baina B. Lavginova Svetlana Yu. Chikina Natalia E. Obukhova Iuliia A. Levina Fedor D. Tkachenko Galina V. Nekludova Zamira M. Merzhoeva Sergey N. Avdeev Predictors of Suboptimal Peak Inspiratory Flow in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Clinical Practice Tuberculosis and Respiratory Diseases chronic obstructive pulmonary disease exacerbation peak inspiratory flow dry powder inhaler inhalation technique |
| title | Predictors of Suboptimal Peak Inspiratory Flow in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Clinical Practice |
| title_full | Predictors of Suboptimal Peak Inspiratory Flow in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Clinical Practice |
| title_fullStr | Predictors of Suboptimal Peak Inspiratory Flow in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Clinical Practice |
| title_full_unstemmed | Predictors of Suboptimal Peak Inspiratory Flow in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Clinical Practice |
| title_short | Predictors of Suboptimal Peak Inspiratory Flow in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Clinical Practice |
| title_sort | predictors of suboptimal peak inspiratory flow in patients with acute exacerbation of chronic obstructive pulmonary disease in clinical practice |
| topic | chronic obstructive pulmonary disease exacerbation peak inspiratory flow dry powder inhaler inhalation technique |
| url | http://e-trd.org/upload/pdf/trd-2024-0154.pdf |
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