help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Reddel, H. K.
Right arrow Articles by Woolcock, A. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Reddel, H. K.
Right arrow Articles by Woolcock, A. J.

Am. J. Respir. Crit. Care Med., Vol 151, No. 5, 05 1995, 1320-1325.

Which index of peak expiratory flow is most useful in the management of stable asthma?

HK Reddel, CM Salome, JK Peat and AJ Woolcock
Institute of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.

Calculation of diurnal peak expiratory flow (PEF) variability using values before and after bronchodilator is no longer possible for many asthmatic patients because they now use beta-agonists "as needed" for symptoms rather than regularly. This study assesses the usefulness of a number of alternative PEF indices as markers of airway liability in subjects with stable, although not necessarily well-controlled, asthma. Forty-six adult subjects completed a questionnaire about symptoms and treatment in the previous 3 mo. Spirometric function and airway hyperresponsiveness (AHR) were assessed; AHR was expressed as dose response ratio (DRR) (maximal percent fall in FEV1 divided by final dose of histamine). Subjects recorded PEF morning and evening, before and after bronchodilator (if used) for 2 wk. Nine different PEF indices were calculated. Diurnal variability (amplitude percent maximum) without bronchodilator was significantly less than diurnal variability with bronchodilator. Normal indices of PEF lability were found in 42% of subjects with reduced maximal midexpiratory flow (MMEF). Most of the PEF indices correlated strongly with DRR, and less strongly with symptom score and airway obstruction. Minimum morning prebronchodilator PEF over a week (expressed as percent recent best or percent predicted) is recommended as the best PEF index of airway lability in patients with stable asthma because it correlates strongly with AHR, patients are more likely to comply with a once-daily reading, the calculation is simple, and regular use of a beta-agonist is not required.


This article has been cited by other articles:


Home page
 J. Appl. Physiol.Home page
C. Diba, C. M. Salome, H. K. Reddel, C. W. Thorpe, B. Toelle, and G. G. King
Short-term variability of airway caliber--a marker of asthma?
J Appl Physiol, July 1, 2007; 103(1): 296 - 304.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
H. Kang, Y. Y. Koh, Y. Yoo, J. Yu, D. K. Kim, and C. K. Kim
Maximal Airway Response to Methacholine in Cough-Variant Asthma: Comparison With Classic Asthma and Its Relationship to Peak Expiratory Flow Variability
Chest, December 1, 2005; 128(6): 3881 - 3887.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
J E M Tomlinson, A D McMahon, R Chaudhuri, J M Thompson, S F Wood, and N C Thomson
Efficacy of low and high dose inhaled corticosteroid in smokers versus non-smokers with mild asthma
Thorax, April 1, 2005; 60(4): 282 - 287.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
M R Miller
The PEF data plot: planning to get the message
Thorax, February 1, 2005; 60(2): 91 - 92.
[Full Text] [PDF]

Home page
 JAOA: Journal of the American Osteopathic AssociationHome page
P. A. Guiney, R. Chou, A. Vianna, and J. Lovenheim
Effects of Osteopathic Manipulative Treatment on Pediatric Patients With Asthma: A Randomized Controlled Trial
J Am Osteopath Assoc, January 1, 2005; 105(1): 7 - 12.
[Abstract] [Full Text] [PDF]

Home page
 The Annals of PharmacotherapyHome page
B. Saini, I. Krass, and C. Armour
Development, Implementation, and Evaluation of a Community Pharmacy-Based Asthma Care Model
Ann. Pharmacother., November 1, 2004; 38(11): 1954 - 1960.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
V. Bellia, F. Pistelli, D. Giannini, N. Scichilone, F. Catalano, M. Spatafora, R. Hopps, L. Carrozzi, S. Baldacci, F. Di Pede, et al.
Questionnaires, spirometry and PEF monitoring in epidemiological studies on elderly respiratory patients
Eur. Respir. J., May 1, 2003; 21(40_suppl): 21S - 27s.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
J.D. Leuppi, C.M. Salome, C.R. Jenkins, H. Koskela, J.D. Brannan, S.D. Anderson, M. Andersson, H.K. Chan, and A.J. Woolcock
Markers of airway inflammation and airway hyperresponsiveness in patients with well-controlled asthma
Eur. Respir. J., September 1, 2001; 18(3): 444 - 450.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. F. Goldstein, B. A. Veza, E. H. Dunsky, D. J. Dvorin, G. A. Belecanech, and I. C. Haralabatos
Comparisons of Peak Diurnal Expiratory Flow Variation, Postbronchodilator FEV1 Responses, and Methacholine Inhalation Challenges in the Evaluation of Suspected Asthma
Chest, April 1, 2001; 119(4): 1001 - 1010.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
F. T. Leone, E. A. Mauger, S. P. Peters, V. M. Chinchilli, J. E. Fish, H. A. Boushey, R. M. Cherniack, J. M. Drazen, J. V. Fahy, J. Ford, et al.
The Utility of Peak Flow, Symptom Scores, and {beta}-Agonist Use as Outcome Measures in Asthma Clinical Research
Chest, April 1, 2001; 119(4): 1027 - 1033.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. D. LEUPPI, C. M. SALOME, C. R. JENKINS, S. D. ANDERSON, W. XUAN, G. B. MARKS, H. KOSKELA, J. D. BRANNAN, R. FREED, M. ANDERSSON, et al.
Predictive Markers of Asthma Exacerbation during Stepwise Dose Reduction of Inhaled Corticosteroids
Am. J. Respir. Crit. Care Med., February 1, 2001; 163(2): 406 - 412.
[Abstract] [Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
G. L. COLICE, J. V. BURGT, J. SONG, P. STAMPONE, and P. J. THOMPSON
Categorizing Asthma Severity
Am. J. Respir. Crit. Care Med., December 1, 1999; 160(6): 1962 - 1967.
[Abstract] [Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
K. GRÜNBERG, M. C. TIMMERS, E. P. A. de KLERK, E. C. DICK, and P. J. STERK
Experimental Rhinovirus 16 Infection Causes Variable Airway Obstruction in Subjects with Atopic Asthma
Am. J. Respir. Crit. Care Med., October 1, 1999; 160(4): 1375 - 1380.
[Abstract] [Full Text]

Home page
 BMJHome page
H. Reddel, C. Jenkins, and A. Woolcock
Diurnal variability---time to change asthma guidelines?
BMJ, July 3, 1999; 319(7201): 45 - 47.
[Full Text]

Home page
 ThoraxHome page
P. L P Brand, E. J Duiverman, H. J Waalkens, E. E M van Essen-Zandvliet, K. F Kerrebijn, and the Dutch CNSLD Study Group
Peak flow variation in childhood asthma: correlation with symptoms, airways obstruction, and hyperresponsiveness during long term treatment with inhaled corticosteroids
Thorax, February 1, 1999; 54(2): 103 - 107.
[Abstract] [Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. BOEZEN, J. SCHOUTEN, B. RIJCKEN, J. VONK, J. GERRITSEN, S. van der ZEE, G. HOEK, B. BRUNEKREEF, and D. POSTMA
Peak Expiratory Flow Variability, Bronchial Responsiveness, and Susceptibility to Ambient Air Pollution in Adults
Am. J. Respir. Crit. Care Med., December 1, 1998; 158(6): 1848 - 1854.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
Research Priorities in Respiratory Nursing
Am. J. Respir. Crit. Care Med., December 1, 1998; 158(6): 2006 - 2015.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 1995 American Thoracic Society