TY - JOUR T1 - The impact of inspiratory effort on inspiratory flow through Turbuhaler in asthmatic patients JF - European Respiratory Journal JO - Eur Respir J SP - 681 LP - 684 DO - 10.1183/09031936.97.10030681 VL - 10 IS - 3 AU - G Persson AU - B Olsson AU - S Soliman Y1 - 1997/03/01 UR - http://erj.ersjournals.com/content/10/3/681.abstract N2 - To investigate the impact of the inhalation effort on the peak inspiratory flow through Turbuhaler, 100 asthmatics having a wide range of asthma severity (baseline forced expiratory volume in one second 28-127% of predicted normal) were studied. Each patient inhaled through four modifications of empty Turbuhaler inhalers, using first a "deep" inhalation and then a "forceful and deep" inhalation manoeuvre. Peak inspiratory flow increased by an average of 20% using a "forceful and deep" as compared to a "deep" inhalation, with a markedly higher increase for the patients who had a low peak inspiratory flow using the deep inhalation. Virtually all patients (97-100%) attained a peak inspiratory flow > or = 40 L x min(-1) after a "forceful and deep" inhalation. This study demonstrates that instructing the patient to take a "forceful and deep" inhalation optimizes the use of Turbuhaler. Irrespective of asthma severity, the vast majority of patients could attain a sufficiently high peak inspiratory flow with a "forceful and deep" inhalation. ER -