| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Guest Access | Sign In via User Name/Password
|
|
|
|||||||
Guest Access | Sign In via User Name/Password |
|||||||||
1 From the Department of Chest Medicine, Sacré-Coeur Hospital, Montreal, Canada
Peak expiratory flow rate (PEFR) monitoring is often used alone in evaluating bronchial caliber and the response to a bronchodilator in the assessment of asthmatic subjects. A 15% change in airway caliber has been proposed as the criteria for modifying treatment. Our aim was to determine if changes in PEFR from one visit to the next can adequately evaluate changes in airway caliber as assessed by FEV1, which is considered the gold standard, and to identify the characteristics of subjects whose evaluations were inadequate. This was a retrospective study of 197 asthmatic subjects seen regularly at an outpatient clinic for whom FEV1 and PEFR assessments, prebronchodilator and postbronchodilator, were available for two visits. There was a high correlation between PEFR and FEV1 (in absolute value or percent predicted) (r=0.83 and r=0.75). However, 24 of 56 (43%) of those who had a change in FEV1 of 15% or more between two visits (mean change [%]±SD, range [best-lowest/best]=20.9±5.1%, 15 to 36%) showed changes in PEFR of less than 15% (6.7±6.5%, 8.0 to 13.9%). On the other hand, 14 of 42 (33%) subjects with changes in FEV1 of less than 15% (9.8±3.2%, 1.1 to 13.8%) had changes in PEFR of 15% or more (22.2±10.9%, 16 to 35%). This discrepancy was not related to differences in baseline FEV1, control status, or the relationship between changes in FEV1 and PEFR in response to a bronchodilator. In conclusion, assessment of airway caliber through PEFR monitoring may not be valid in some asthmatic subjects and can often lead to underestimation or overestimation of changes in FEV1. None of the explanations considered made it possible to identify these subjects.
Key Words: airway caliber • airway obstruction • asthma • FEV1 • maximal expiratory flow rates • obstructive lung diseases • PEFR
Submitted on November 1, 1993
Accepted on April 5, 1994
This article has been cited by other articles:
|
|
 |
|
  M. J. Hegewald, M. J. Lefor, R. L. Jensen, R. O. Crapo, S. B. Kritchevsky, C. L. Haggerty, D. C. Bauer, S. Satterfield, T. Harris, and for the Health, Aging, and Body Composition Study Peak Expiratory Flow Is Not a Quality Indicator for Spirometry: Peak Expiratory Flow Variability and FEV1 Are Poorly Correlated in an Elderly Population Chest, May 1, 2007; 131(5): 1494 - 1499. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Fonseca, A. Costa-Pereira, L. Delgado, L. N. Silva, M. Magalhaes, M. G. Castel-Branco, and M. Vaz Pulmonary Function Electronic Monitoring Devices: A Randomized Agreement Study Chest, September 1, 2005; 128(3): 1258 - 1265. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. M. Harirah, S. E. Donia, F. K. Nasrallah, G. R. Saade, and M. A. Belfort Effect of Gestational Age and Position on Peak Expiratory Flow Rate: A Longitudinal Study Obstet. Gynecol., February 1, 2005; 105(2): 372 - 376. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M Tovar and J. G Gums Monitoring Pulmonary Function in Asthma and COPD: Point-of-Care Testing Ann. Pharmacother., January 1, 2004; 38(1): 126 - 133. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Crapo Guidelines for Methacholine and Exercise Challenge Testing---1999 . THIS OFFICIAL STATEMENT OF THE AMERICAN THORACIC SOCIETY WAS ADOPTED BY THE ATS BOARD OF DIRECTORS, JULY 1999 Am. J. Respir. Crit. Care Med., January 1, 2000; 161(1): 309 - 329. [Full Text]
|
|
|
|
|
|
C. G. IRVIN, R. J. MARTIN, V. M. CHINCHILLI, S. J. KUNSELMAN, and R. M. CHERNIACK Quality Control of Peak Flow Meters for Multicenter Clinical Trials Am. J. Respir. Crit. Care Med., July 1, 1997; 156(2): 396 - 402. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
