Practical Experience with the Peak Flow Meter

Lockhart, W. R.; Smith, David H.; Mair, Alexander; Wilson, W. A.

doi:10.1136/bmj.1.5165.37

Cited by 50 publications

(21 citation statements)

References 7 publications

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“…Using the peak flow meter, we have found the coefficient of variation of triplicate readings to be 4.5% for expiration, which is similar to that reported by Lockhart et al (1960), Shephard (1962), and Fairbairn, Fletcher, Tinker, and Wood (1962). For P.I.F.…”

supporting

confidence: 86%

“…As an expression of ventilatory capacity the peak flow has been challenged because it records flow only over the very short time interval of 10 millisecs. Nevertheless it has been shown to parallel other measurements of ventilatory function and to discriminate between grades of disability and symptoms in several studies (Lockhart, Smith, Mair, and Wilson, 1960;Prime, 1960;Fletcher and Tinker, 1961 ; College of General Practitioners, 1961 ; Read and Selby, 1961).Expiratory flow can be reduced by many different mechanisms, such as narrowing of the bronchial lumen by tumour, mucosal swelling, secretions, smooth-muscle spasm, or inward collapse of the bronchial walls. The bronchial collapse mechanism occurs in emphysema on expiration and is explained by lack of support for the walls and by the fall in intrabronchial pressure normally derived from the elastic recoil of the lungs.…”

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confidence: 93%

mentioning

confidence: 96%

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Adaptation of the Wright Peak Flow Meter to Measure Inspiratory Flow

Nairn¹,

McNeill²

1963

BMJ

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(1959). This instrument, now known as the Wright peak flow meter, has become popular because of its ease of use, portability, and mechanical reliability. As an expression of ventilatory capacity the peak flow has been challenged because it records flow only over the very short time interval of 10 millisecs. Nevertheless it has been shown to parallel other measurements of ventilatory function and to discriminate between grades of disability and symptoms in several studies (Lockhart, Smith, Mair, and Wilson, 1960;Prime, 1960;Fletcher and Tinker, 1961 ; College of General Practitioners, 1961 ; Read and Selby, 1961).Expiratory flow can be reduced by many different mechanisms, such as narrowing of the bronchial lumen by tumour, mucosal swelling, secretions, smooth-muscle spasm, or inward collapse of the bronchial walls. The bronchial collapse mechanism occurs in emphysema on expiration and is explained by lack of support for the walls and by the fall in intrabronchial pressure normally derived from the elastic recoil of the lungs. Inspiration remains relatively unimpaired, and for this reason a comparison of the expiratory and inspiratory spirograms is useful and has been recommended (Ciba Symposium, 1959; W.H.O., 1961). Using a light spirometer and rapid kymograph McNeill, Malcolm, and Brown (1959) compared the maximum expiratory and inspiratory flow by measuring the time taken to expire and inspire a litre of gas between 200 and 1,200 ml. and converting this to litres per minute. This method has been described by Comroe, Forster, Dubois, Briscoe, and Carlsen (1955), with the claim that it gave values comparable to those obtained by an electrical pneumotachograph. In an attempt to obtain similar information rapidly and easily and without the necessity for spirometer or kymograph, we have adapted the Wright peak flow meter to measure inspiratory flow.Description and Characteristics of the Meter A gasket has been applied around the rim of the exhaust portholes of the meter and a " perspex " back with exit pipe has been screwed on to make an airtight joint (Fig. 1). The back clears the meter by 2 cm. The exit pipe is 4.5 cm. long and has the same diameter as the inlet pipe, so that the plastic mouthpiece can be inserted at either end. The subject applies his mouth to the exit side and expires gently but fully. He then reverses suddenly and inspires at maximum speed. This manceuvre is more difficult to learn than forced expiration, but it can usually be mastered after two or three trials.The addition of the back portion raised the possibility of increased resistance to expiration. To test this, the peak expiratory flow (P.E.F.) of 12 subjects was measured with and without the back portion and there was no significant difference in the results.The meter was also calibrated with the back both on and off against known steady flow rates. These were produced by pumping air into a vessel at constant pressure and allowing it to flow through a calibrated pipe orifice meter. As can be seen (Fig. 2)

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confidence: 86%

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confidence: 93%

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confidence: 96%

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Adaptation of the Wright Peak Flow Meter to Measure Inspiratory Flow

Nairn¹,

McNeill²

1963

BMJ

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“…2 This is commonly used to monitor lung function in asthmatics. The peak flow generated via this method is much greater than the peak airflow during phonation, as it generated through an open glottis with a much reduced resistance.…”

Section: Mechanics Of the Voicementioning

confidence: 99%

Peak Flow and Voice Pathology

2009

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“…Regular measurement of peak flow allows objective determination of effect of therapy 40,41 . Peak flow measurement can be used to titrate maintenance treatment and deserve wider use in monitoring the adequacy of treatment of asthma 42 .…”

Section: Lowestpefr R Highestpefmentioning

confidence: 99%

Peak Expiratory Flow Rate (PEFR)-A Simple Ventilatory Lung Function Test

Mrindha

Amin²,

Kabir

2012

J Shaheed Suhrawardy Med Coll

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Peak expiratory flow rate (PEFR) is the maximal expiratory flow rate sustained by a subject for at least 10 milliseconds expressed in Litre per minute (L/min). PEFR is a simple, reliable, reproducible and easily measurable ventilatory lung function test. This simple test had been measured by various types and shapes of instruments for long since, now miniWright peak flow meter is widely used to measure the of PEFR values. Mini-Wright peak flow meter is cheap, easily portable and reproducible device for PEFR even below the age 5 years. Different countries use their own nomogram or prediction equation to find out mean PEFR values of particular height. Similarly, the prediction equation for calculation of PEFR values of Bangladeshi boys and girls are 5.96XHeight-495 and 5.70XHeight-479 respectively. Peak expiratory flow rate is very useful tool for diagnosis, management and follow up of reversible airway diseases.

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Practical Experience with the Peak Flow Meter

Cited by 50 publications

References 7 publications

Adaptation of the Wright Peak Flow Meter to Measure Inspiratory Flow

Adaptation of the Wright Peak Flow Meter to Measure Inspiratory Flow

Peak Flow and Voice Pathology

Peak Expiratory Flow Rate (PEFR)-A Simple Ventilatory Lung Function Test

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