Your power of inhalation – PIFotal

Measurement of the power of your inhalation

Thank you for your participation in the PIFotal study. During the visit, the power of your inhalation has been assessed - in other words: Peak Inspiratory Flow Rate (PIFR) - measured with the In-Check DIAL.

The researcher has provided you with the results of the so-called PIFR outcomes. The results of the typical PIFR represents the power of inhalation when you inhale against the resistance equal to your own inhaler. The results of the maximal PIFR represents the power of your inhalation, with a maximal effort, against the resistance equal to your own inhaler. Is the result of the maximal PIFR lower than the value in the column ‘Required minimal PIFR’? Please discuss with your healthcare professional whether your current device is optimal for you.

Inhaler	Required minimal PIFR*	Optimal PIFR*
Ellipta	30 L/min	60 L/min
Turbuhaler	30 L/min	60 L/min
Breezehaler	50 L/min	50 L/min
Genuair	40 L/min	45 L/min
Novolizer	35 L/min	50 L/min
Spiromax	40 L/min	40 L/min
Diskus	30 L/min	60 L/min
Handihaler	20 L/min	30 L/min
Nexthaler	35 L/min	35 L/min
Cyclohaler (Aerolizer)	40 L/min	65 L/min
Easyhaler	30 L/min	30 L/min
Forspiro	30 L/min	60 L/min
Elpenhaler	30 L/min	60 L/min
Twisthaler	30 L/min	unknown
Zonda	20 L/min	39 L/min

*Sources:
1. Ghosh, S., Ohar, J. A., & Drummond, M. B. (2017). Peak Inspiratory Flow Rate in Chronic Obstructive Pulmonary Disease: Implications for Dry Powder Inhalers. Journal of aerosol medicine and pulmonary drug delivery, 30(6), 381–387.
2. Haidl P, Heindl S, Siemon K, Bernacka M, Cloes RM. Inhalation device requirements for patients' inhalation maneuvers. Respir Med. 2016;118:65-75. doi:10.1016/j.rmed.2016.07.013.
3. van der Palen J. Peak inspiratory flow through diskus and turbuhaler, measured by means of a peak inspiratory flow meter (In-Check DIAL). Respir Med. 2003;97(3):285-289.
4. Clark, A. R., Weers, J. G., & Dhand, R. (2020). The Confusing World of Dry Powder Inhalers: It Is All About Inspiratory Pressures, Not Inspiratory Flow Rates. Journal of aerosol medicine and pulmonary drug delivery, 33(1), 1–11.
5. Comparison of inspiratory flow rates using an innovative dry powder inhaler (DPI) in patients with mild–severe asthma and severe COPD Spencer Jones, Ingolf Gath, Thomas Weuthen European Respiratory Journal 2014 44: P941;
6. Virchow JC, Weuthen T, Harmer QJ, Jones S. Identifying the features of an easy-to-use and intuitive dry powder inhaler for asthma and chronic obstructive pulmonary disease therapy: results from a 28-day device handling study, and an airflow resistance study. Expert Opin Drug Deliv. 2014;11(12):1849-1857. doi:10.1517/17425247.2014.949236
7. de Boer AH, Gjaltema D, Hagedoorn P, Frijlink HW. Can 'extrafine' dry powder aerosols improve lung deposition? Eur J Pharm Biopharm. 2015 Oct;96:143-51. doi: 10.1016/j.ejpb.2015.07.016. Epub 2015 Jul 26. PMID: 26220014.

In case you have any questions concerning this information, please do not hesitate to contact one of our researchers by calling: (02) 9114 0479 or by sending an email to: woolcock.respimedicines@sydney.edu.au