Peak expiratory flow rate

PEFR Peak expiratory flow rate QS Quantity sufficient... 

Obstructive disease reduces peak expiratory flow rate (PEFR) and increases RV via gas trapping. The TLC may also be higher although this is difficult to demonstrate without values on the x axis. The important point to demonstrate is reduced flow rates during all of expiration, with increased concavity of the expiratory limb owing to airway obstruction. The inspiratory limb is less affected and can be drawn as for the normal curve but with slightly lower flow rates. 

McMillan, R. S., D. H. Wiseman, B. Hanes, and P. F. Wehrle. Effect of oxidant air pollution on peak expiratory flow rates in Los Angeles school children. Arch. Environ. Health 18 941-949, 1%9. 

Contact allergy to glucocorticoids is not rare in patients with atopic dermatitis. In patients with known contact allergy to budesonide, allergic skin reactions can also occur when inhaled forms of the drug are used, as shown by a randomized, double-bhnd, placebo-controlled study in 15 non-asthmatic patients with budesonide hypersensitivity on patch testing (101). In four of seven patients who used inhaled budesonide, there was reactivation of the 6-week-old patch test sites and they had new distant skin lesions. No flare-up reactions were observed in the other 11 patients (three had used inhaled budesonide and eight placebo for 1 week). None of the patients developed respiratory symptoms spirometry and peak expiratory flow rates remained normal. 

Respiratory Lung function Spirometry and pulmonary function testing (measurements of lung volumes and flow rates) peak expiratory flow rate measurements (can be done in field with inexpensive hand-held meters)... 

Effects of leukotriene modifiers in patients with chronic persistent asthma. PEFR = peak expiratory flow rate. 

Peak flow measurement of peak expiratory flow rate (PEFR) on waking, before bed, before and after bronchodilator medication is useful to assess the extent of airflow limitation and the characteristic of the disease in terms of reversibility. There is some evidence of diurnal variability. PEFR is also useful in assessing the disease progression longer term and the response to therapy. Patients are advised to keep an asthma diary and record regularly the peak flows to ascertain their diurnal pattern. 

Abbreviations QOAD, chronic obstructive airway disease FEFM, forced expiratory flow rate at 50% vital capacity FEFJSJ forced expiratory flow rate at 25% vital capacity FE V forced expiratory volume at Is NR, not reported PEFR, peak expiratory flow rate Raw, airway resistance TLC, total lung capacity. 

Q8 Brad s FEVi and peak expiratory flow rate are a little lower than expected for a person of his age and height. The FVC is just a little higher than expected. The low peak flow and FEVi suggests that he may now be experiencing some obstruction to expiration. 

By peak expiratory flow rate (PEFR) every 15-30 minutes... 

Two vegetable warehouse workers developed occupational rhinitis and bronchial asthma by sensitization to C. scolymus (17). Skin prick tests to artichoke were positive and IgE specific for artichoke was found. Nasal challenge with artichoke extract triggered a reduction in peak nasal inspiratory flow of 81 and 85%. One patient had a reduction in peak expiratory flow rate of up to 36% after exposure to artichoke in the workplace. 

Return of normal respiration can take up to 23 hours. Peak expiratory flow rate (PEER) was significantly better in patients who had received intrathecal rather than intravenous morphine after cardiac surgery, but mean PaC02 was significantly higher in patients given intrathecal morphine 2 mg, rather than intrathecal or intravenous morphine 1 mg (113). The effect was dose-dependent (114). 

Salmeterol 42 micrograms bd has been compared with inhaled ipratropium bromide 36 micrograms/day and inhaled placebo in a randomized, double-blind study for 12 weeks in 405 patients with chronic obstructive pulmonary disease (6). Both salmeterol and ipratropium bromide significantly increased the peak expiratory flow rate compared with placebo. Non-specific ear, nose, and throat symptoms (for example sore throat and upper respiratory tract infections) were more common with salmeterol and ipratropium than placebo. There were no significant differences between the groups in the total number of ventricular and supraventricular extra beats. There was no tolerance to the bronchodilating effects of salmeterol. 

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