Background: Inhaled medication through dry powder inhalers is widely used in children, but pediatric studies focussing on the ages at which these devices can be used are sparse.
Objective: To establish the difference in peak inspiratory flow (PIF) through Accuhaler and Turbuhaler in healthy children using a new device, In-check, and to determine the differences between the two different models of this device.
Methods: PIF was measured in 64 healthy male children (mean age 11.2 years, range 8.8-14.7) by means of In-check and In-check Dial using Accuhaler and Turbuhaler resistances. The best attempt of three was chosen. Height,weight, and forced expiratory volume in 1 second were also measured.
Results: Significant differences in PIF were found between the two inhalers: PIF In-check Accuhaler-PIF In-check Turbuhaler (134.4 +/- 15.5 L/min vs 99.9 6 +/- 11.1 L/min; p<0,000) and PIF In-check Dial Accuhaler-PIF In-check Dial Turbuhaler (109.6+/-10.5 L/min vs 86.8+/-8.9 L/min; p<0.000). The best correlation obtained among the different In-check measurements was between In-check Ac-cuhaler and In-check Turbuhaler (r=0.88; p<0.001), and the worst was between In-check Dial Accuhaler and In-check Turbuhaler (r =0.71; p<0.001).
Conclusions: PIF through Accuhaler is significantly higher than that through Turbuhaler, although in both cases PIF was sufficient to provide adequate distribution of the inhaled medication in children aged 9-14 years. Consequently, in children younger than 9 years old, and especially during an asthma attack, In-check should be tried in order to discover whether the child is capable of using Turbuhaler correctly.