[Usefulness of breath actuated devices in asthmatic children with bronchial obstruction].

Clinical efficacy of breath actuated devices depends on value of peak inspiratory flow (PIF). Therefore the aim of our study was to assess PIF Rate (PIFR) in asthmatic children with bronchial obturation (FEV1%FVC < lower limit of normal). Thirty five children aged (average) 11.5 years participated in the study. PIFR was obtained with InCheck (Clement Clark, UK) with resistance valves for Turbuhaler, Discus, Easi Breathe and Autohaler inhalers, then peak inspiratory flow was assessed spirometrically (LungTest 1000, MES SJ, Poland). Maximal value of PIFR (PIFRmax=120 l/min) was obtained by 24 (69%) children for Easi Breathe, 3 (9%) children for Autohaler, 2 (6.5%) children for Discus, for Turbuhalera none of the children reached PIFRmax, differences in assessing PIFRmax were statistically significant (p < 0.05). However, all the children were able to generate minimal and optimal PIFR for all inhalers. There were no correlation between the degree of bronchial obstruction and PIFR values, but significant correlation was found between spirometric PIF and PIFR for different devices. All four tested inhalers can be used by children with bronchial obstruction, and the highest PIFR (as well as most frequently maximal PIFR) is obtained with Easi Breathe inhaler.