SynthesisInternational journal of chronic obstructive pulmonary disease
Lung Deposition and Inspiratory Flow Rate in Patients with Chronic Obstructive Pulmonary Disease Using Different Inhalation Devices: A Systematic Literature Review and Expert Opinion.
Synthesis in International journal of chronic obstructive pulmonary disease. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 49 citations in OpenAlex.
- Advanced Pulmonary Drug Delivery Systems: A Narrative Review.Pulmonary therapy · 2026Review
- Comprehensive Evaluation of Storage Stability and Cytotoxicity of Co-Spray-Dried Theophylline Dry Powders for Inhalation: Follow-Up Study.Pharmaceutics · 2026Article
- Therapeutic Simplification in COPD and Its Impact on RADAR Control: Treatment-Burden Reduction, Responder Profile and Structural-Behavioral Trajectories.Journal of clinical medicine · 2026Article
- CFD study on deposition pattern of adult oropharyngeal drug particles with inhalation devices using realistic anatomical models under steady-state flow.Pharmaceutical research · 2026Article
- Real-World Outcomes in Patients with COPD Initiating Budesonide/Glycopyrronium/Formoterol Fumarate Dihydrate After Dual and Triple Therapy in Spain: A Sub-Study of the ORESTES Study.Pulmonary therapy · 2026Article
- Small airway dysfunction: a shared, early, measurable, and potentially treatable trait across COPD, asthma, and fibrotic lung disease.Frontiers in medicine · 2026Review
- A Proposed Checklist for Optimizing COPD Patient Discharge Processes in Italian Internal Medicine Wards.International journal of chronic obstructive pulmonary disease · 2026Review
- Hair analysis for monitoring adherence to inhaled respiratory medications: possibilities and limitations.European journal of clinical pharmacology · 2025Review
- Flow Profiles Identify Sources of Poor Metered Dose Inhaler Technique: An Observational Study in Patients with Long-Term Pressurized Metered Dose Inhaler Use.CHEST pulmonary · 2025Article
- An Estimation of the Economic and Environmental Impact of Inhaler Devices Switch for Non-Clinical Reasons in COPD and Asthma: The Case for Spain.Journal of market access & health policy · 2025Article
- Inhaled non-viral delivery systems for RNA therapeutics.Acta pharmaceutica Sinica. B · 2025Review
- Scale-Up and Postapproval Changes in Orally Inhaled Drug Products: Scientific and Regulatory Considerations.Journal of aerosol medicine and pulmonary drug delivery · 2025Review
- Challenges and Opportunities in COPD Management in Latin America: A Review of Inhalation Therapies and Advanced Drug Delivery Systems.Pharmaceutics · 2024Review
- Inhalational Drug Devices: Revisiting the Linchpin of Asthma Management.Journal of personalized medicine · 2024Review
- The effects of airway disease on the deposition of inhaled drugs.Expert opinion on drug delivery · 2024Review
- Current approaches in smart nano-inspired drug delivery: A narrative review.Health science reports · 2024Article
- Aerosol Plumes of Inhalers Used in COPD.Pulmonary therapy · 2024Article
- Demystifying Dry Powder Inhaler Resistance with Relevance to Optimal Patient Care.Clinical drug investigation · 2024Review
- Recalibrating Perceptions and Attitudes Toward Nebulizers versus Inhalers for Maintenance Therapy in COPD: Past as Prologue.International journal of chronic obstructive pulmonary disease · 2024Review
- Implementing an Evidence-Based COPD Hospital Discharge Protocol: A Narrative Review and Expert Recommendations.Advances in therapy · 2023Review
Corrections and comments
- Erratum issued
Authors and funding
10 authors at 9 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOur aim was to describe: 1) lung deposition and inspiratory flow rate; 2) main characteristics of inhaler devices in chronic obstructive pulmonary disease (COPD).
methodsA systematic literature review (SLR) was conducted to analyze the features and results of inhaler devices in COPD patients. These devices included pressurized metered-dose inhalers (pMDIs), dry powder inhalers (DPIs), and a soft mist inhaler (SMI). Inclusion and exclusion criteria were established, as well as search strategies (Medline, Embase, and the Cochrane Library up to April 2019). In vitro and in vivo studies were included. Two reviewers selected articles, collected and analyzed data independently. Narrative searches complemented the SLR. We discussed the results of the reviews in a nominal group meeting and agreed on various general principles and recommendations.
resultsThe SLR included 71 articles, some were of low-moderate quality, and there was great variability regarding populations and outcomes. Lung deposition rates varied across devices: 8%-53% for pMDIs, 7%-69% for DPIs, and 39%-67% for the SMI. The aerosol exit velocity was high with pMDIs (more than 3 m/s), while it is much slower (0.84-0.72 m/s) with the SMI. In general, pMDIs produce large-sized particles (1.22-8 μm), DPIs produce medium-sized particles (1.8-4.8 µm), and 60% of the particles reach an aerodynamic diameter <5 μm with the SMI. All inhalation devices reach central and peripheral lung regions, but the SMI distribution pattern might be better compared with pMDIs. DPIs' intrinsic resistance is higher than that of pMDIs and SMI, which are relatively similar and low. Depending on the DPI, the minimum flow inspiratory rate required was 30 L/min. pMDIs and SMI did not require a high inspiratory flow rate.
conclusionLung deposition and inspiratory flow rate are key factors when selecting an inhalation device in COPD patients.
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