Question
What factors influence the accuracy and consistency of peak expiratory flow measurements in asthma patients?
Answer
Accurate peak expiratory flow (PEF) readings depend on proper technique and consistent effort during measurement. Since peak flow is determined during the initial 200 milliseconds of a forceful exhalation, it is crucial that patients begin each effort with a full inhalation followed by an immediate and vigorous exhale. To minimize variability, patients should complete at least three efforts, aiming for results that vary by no more than 40 liters per minute. If significant variation occurs, additional attempts are recommended to obtain a reliable value.
Peak flow meters display results in liters per minute, whereas some spirometers may report airflow in liters per second. This distinction is important when comparing values or recording results, especially in clinical settings. Patients should be instructed to document only the highest of the three attempts in their diary, as this will serve as their reference point for evaluating future readings. Once the personal best is established, it becomes a key component of their asthma action plan, enabling them to make timely treatment decisions based on zone thresholds. Accurate, consistent measurements are essential to empower patients in managing their asthma proactively and effectively.
This Ask the Expert is an edited excerpt from the course, Objective Measures of Asthma, presented by Kevin Collins, PhD, RRT, RPFT, AE-C.
