Micropeak

The participants performed PEFR with a peak flow matter (PEF) with a standard range of 60–900 L/min (MicroPeak, CareFusion) before, after 60, 120, and 150 min of the trial. Additionally, the patients leaving the Institute received PEF in order to self‐test at home 4 and 24 h after exposure.

Respiratory evaluations were performed before starting treatment and at different time points during follow-up (4, 7, 12, 18, 26 and 30 months after treatment). The following measurements of respiratory function were recorded in each visit: standard spirometry for FVC (Jaeger MasterScope, Carefusion, Hoechberg, Germany), MIP, MEP and SNIP (MicroRPM, Carefusion, Hoechberg, Germany), CPF (MicroPeak, Carefusion, Hoechberg, Germany), blood arterial gas for pH, paCO₂, paO₂ and HCO₃ (Gem Premier 4000, Instrumentation Laboratory, Bedford, Massachusetts, USA), nocturnal pulse oximeter for SpO₂ and CT90 (Pulsox 300i, Konica Minolta, Tokyo, Japan), a BiPAP (Bilevel Positive Airway Pressure) built in software assessment for IPAP (inspiratory positive airway pressure), EPAP (expiratory positive airway pressure), daily use of the device in hours and average number of spontaneous breaths (Philips DirectView, Murrysville, Pennsylvania, USA, and Resmed ResScan, Australia) and the need for mechanical cough assistance techniques (CoughAssist, Philips Respironics, Murrysville, Pennsylvania, USA). All respiratory function tests were performed according to international ATS/ERS (American Thorax Society / European Respiratory Society) guidelines.13 (link)