Determination of peak expiratory flow

Kano, S., Burton, D.L., Lanteri, C.J. and Sly, P.D. (1993) Determination of peak expiratory flow. European Respiratory Journal, 6 9: 1347-1352.

Author Kano, S.
Burton, D.L.
Lanteri, C.J.
Sly, P.D.
Title Determination of peak expiratory flow
Journal name European Respiratory Journal   Check publisher's open access policy
ISSN 0903-1936
Publication date 1993-10
Sub-type Article (original research)
Volume 6
Issue 9
Start page 1347
End page 1352
Total pages 6
Place of publication Lausanne, Switzerland
Publisher European Respiratory Society
Language eng
Abstract It is still unknown whether peak expiratory flow (PEF) is determined by 'wave speed' flow limitation in the airways. To investigate the influences of airway mechanical properties on PEF, five healthy adults performed maximal forced expiratory effort (MFEE) manoeuvres, in the standard manner and following breathholds at total lung capacity (TLC) of 2 s and 10 s. Oesophageal pressure (Poes) was measured as an index of respiratory effort. Subjects also performed a MFEE following a 10 s breathhold during which intrathoracic pressure was voluntarily raised by a Valsalva manoeuvre, which would increase transmural pressure and cross-sectional area of the extrathoracic airway. Addition MFEEs were performed with the neck fully flexed and extended, to change longitudinal tracheal tension. In separate studies, PEF was measured with a spirometer and with a pneumotachograph. Breathholds at TLC (2 s and 10 s), and neck flexion reduced PEF by a mean of 9.8% (SD 2.9%), 9.6% (SD 1.6%), and 8.7% (SD 2.8%), respectively, when measured with the spirometer. The same pattern of results was seen when measured with the pneumotachograph. These reductions occurred despite similar respiratory effort. Voluntarily raising intrathoracic pressure during a 10 s breathhold did not reverse a fall in PEF. MFEE manoeuvre with neck extension did not result in an increase in PEF, the group mean % changes being -3.0% (SD 5.0%). We conclude that these results do not allow the hypothesis that 'wave-speed' (V̇ws) is reached at PEF to be rejected. A breathhold at TLC could increase airway wall compliance by allowing stress-relaxation of the airway, thus reducing the 'V̇ws' achievable.
Keyword Flow limitation
Peak expiratory flow
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Wed, 17 Nov 2010, 11:34:24 EST