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Peak Expiratory Flow With or Without a Brief Postinspiratory Pause*

Tariq Omar, MD; Husain Alawadhi, MD; Ayman O. Soubani, MD, FCCP; George E. Tzelepis, MD, FCCP
Author and Funding Information

*From the Wayne State University School of Medicine (Drs. Omar, Alawadhi, Soubani, and Tzelepis), Detroit, MI; and University of Athens Medical School (Dr. Tzelepis), Athens, Greece.

Correspondence to: George E. Tzelepis, MD, FCCP, Department of Pathophysiology, University of Athens Medical School, 75 M Asias St, 11527 Athens, Greece; e-mail:gtzelep@med.uoa.gr



Chest. 2005;128(1):442-445. doi:10.1378/chest.128.1.442
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Background: The duration of postinspiratory pause prior to forced expiration may significantly influence the peak expiratory flow (PEF) measured during maximal forceful expirations. In comparison with maneuvers without a postinspiratory pause, maneuvers with 4 to 6-s pause at total lung capacity (TLC) result in decreased PEF values. The extent to which brief pauses (< 2 s) similarly affect PEF values is unknown.

Methods: Thirty-six healthy volunteers (mean [±SD] age, 35 ± 8 years; 18 men) performed a series of maximal forceful expirations with two different types of maneuvers. One maneuver (NP) included no inspiratory pause at TLC prior to forceful expiration, whereas the second (P) included a brief pause (≤ 2 s). The speed of inhalation to TLC was rapid and similar for both maneuvers. The highest PEF for each maneuver was used for analysis.

Results: The maximal PEF did not differ (p > 0.05) between the P and NP maneuvers (7.78 ± 1.45 vs 7.83 ± 1.45 L/s, respectively). Comparison of the intermaneuver differences showed a bias of 0.05 L/s and 95% confidence interval in the range of −0.9 to 1.0 L/s.

Conclusions: Forceful expiratory maneuvers with or without postinspiratory pauses of ≤ 2 s produce identical maximal PEF values and, therefore, can be used interchangeably for the spirometric measurement of PEF in healthy subjects.

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