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Are we recording peak flows properly in young children?
A Greenough1, L Everett, J F Price
1Paediatric Respiratory Laboratory, King's College Hospital, London, UK.
The European Respiratory Journal
|November 1, 1990
Summary
Three peak flow maneuvers are often insufficient for young children to achieve their maximum peak expiratory flow rate (PEFR). A median of 7% higher PEFR was observed in the second set of three blows, indicating more attempts are needed for accurate asthma monitoring.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Asthma Management
Background:
- Peak expiratory flow rate (PEFR) is crucial for monitoring asthma in children.
- Current practice often relies on the best of three PEFR maneuvers.
- The adequacy of three maneuvers for capturing maximum PEFR in young children is uncertain.
Purpose of the Study:
- To evaluate if three peak flow maneuvers are sufficient to obtain the maximum peak flow rate in young children.
- To determine the reproducibility of PEFR measurements in this age group.
Main Methods:
- Thirty-nine children aged 3-10 years participated.
- Peak expiratory flow rate (PEFR) was measured six times per child at 2-minute intervals.
- Comparison of maximum PEFR from the first three vs. the second three maneuvers.
Main Results:
- Less than half of children (13/39) achieved their maximum PEFR within the first three maneuvers.
- The maximum PEFR from the second set of three blows was a median of 7% greater than the first set.
- A PEFR change greater than 17.6% is needed to demonstrate bronchodilator response, based on an 8.8% coefficient of variation.
Conclusions:
- Three peak flow maneuvers are insufficient for the majority of young children to achieve their maximum PEFR.
- Additional maneuvers are recommended for accurate home monitoring and assessment of bronchodilator response in pediatric asthma.
- Standardizing PEFR measurement protocols is essential for reliable asthma management in children.