최대호기속도 측정에서 Mini Wright Peak Flow Meter와 Microplns Pocket Spirometer의 비교

나영호,배종우,정사준 대한 소아알레르기 및 호흡기학회 1999 소아알레르기 및 호흡기학회지 Vol.9 No.2

목 적 : 최대호기속도(peak expiratory flow rate PEFR)와 같은 간단한 폐기능 측정은 기도폐쇄 정도의 평가와 천식 환자의 감시에 유용하게 사용되고 있다. 특히 기관지천식 환자에서 반복적으로 측정된 PEFR치는 환자의 경과를 관찰하는데 객관적인 지표로서 그 가치가 높다. PEFR 측정에는 mini-Wright peak flow meter가 주로 사용되고 있으나 최근에는 PEFR 이외에 FEV_1 및 FVC를 측정할 수 있는 Microplus pocket spirometer도 사용되고 있는 바, 본 연구자들은 PEFR 측정에 있어서 신뢰도가 검증된 mini-Wright peak flow meter와 Microplus pocket spirometer를 비교하고자 본 연구를 시행하였다. 방 법 : 연구 대상은 건강한 11-12세의 초등학생 80명(남아 37명, 여아43명)으로 하였으며 이들은 조사 당시에 상기도 감염이나 기도 폐쇄 소견이 없었다. PEFR은 일정한 간격을 두고 mini-Wright peak flow meter(Clemente Clark, UK)와 Microplus pocket spirometer(Micro Medical, Ltd. UK)를 임의의 순서로 사용하여 각각 3회 측정하였다. 두 기구에 의한 각각의 PEFR 측정치간의 일치성(95% limits of agreement)과 각 기구에 의한 측정치의 재현성(repeatability coefficient)을 Bland와 Altman에 의해서 고안된 통계학적 방법으로 분석하였다. 결 과: 1) 76명(95%)에서 Microplus pocket spirometer가 mini-Wright Beak flow meter보다 낮은 PEFR치를 나타냈다. 2) 두 기구의 PEFR 측정치의 95% limits of agreement는 2.7 L/min에서 144.3 L/min으로 차이범위가 넓었으며 측정치의 최대차이는 141.6 L/min 이었다. 3) mini-Wright peak flow meter와 Microplus pocket spirometer로 측정한 PEFR의 측정치의 재현성(reproducibility)을 나타내는 repeatability coefficient는 각각 27 L/min과 33.5 L/min로 Microplus pocket spirometer에서 높았다. 4) 두 기구의 사용 순서나 성별에 따른 PEFR 측정치의 유의한 차이는 없었다. 결 론 : Microplus pocket spirometer는 mini-Wright peak flow meter와 PEFR 측정치의 비교에서 유사한 재현성을 보였으나 넓은 95% limit of agreement를 나타내어 두 기구간에 낮은 일치성을 보였다. 따라서 PEFR 측정에 의한 주기적인 폐기능의 감시에는 같은 기기를 계속 사용하는 것이 보다 정확하고 객관적인 폐기능 수치를 얻을 수 있을 것으로 사료된다. Purpose : Peak expiratory flow rate(PEFR) monitoring plays an important role in the diagnosis of airway obstruction and management of patients with bronchial asthma. This study compared the PEFR taken by a Microplus pocket spirometer and mini-Wright peak flow meter by assessing the extent of agreement between the instruments and the repeatability of measurements with each instrument. Methods : Eighty healthy children(age 11-12 years, 43 females, 37 males) performed three PEFR maneuvers on the Microplus pocket spirometer and on the mini-Wright peak flow meter in a random order. Agreement and reproducibility between the two instruments were assessed by the statistical methods proposed by Bland and Altman. Results : Seventy six(95%) of the PEFR taken by the mini-Wright peak flow meter were higher than that of Microplus pocket spirometer. The 95% limits of agreements(mean difference±2SD) between each instrument were very wide(2.7 to 144.3 L/min). The repeatability coefficient for the mini-Wright peak flow meter was 27 L/min and for the Microplus pocket spirometer was 33.5 L/min. Analysis by sex and order of usage did not show any significant differences. Conclusion : The limit of agreement between the Microplus pocket spirometers and the mini-Wright peak flow meter was too wide to use interchangeably.

속도계측형 호흡기류센서에서 상승시간을 고려한 최고호기유량의 교정 기법

차은종(Eun-Jong Cha),이인광(In-Kwang Lee),김성식(Seong-Sik Kim),김완석(Wan-Suk Kim),박경순(Kyung-Soon Park),김원재(Wun-Jae Kim),김경아(Kyung-Ah Kim) 대한전기학회 2009 전기학회논문지 Vol.58 No.4

Peak expiratory flow rate(PEF) is one of the most important diagnostic parameters in spirometry. PEF occurs in a very short duration during the forced expiratory maneuver, which could lead to measurement error due to non-ideal dynamic characteristic of the transducer. In such case the initial slope of the flow rate signal determines the accuracy of the measured PEF. The present study considered this initial slope as a parameter to compensate PEF. The 26 standard flow rate signals recommended by the American Thoracic Society(ATS) were flown through the air flow transducer followed by simultaneous measurements of PEF and maximum transducer output(NPEF). NPEF-PEF satisfied a quadratic equation in general, however, two signals(ATS #2 and #26) having large initial slopes deviated from the fitting equation to a significant degree. The relative error was found to be in a linear relationship with the initial slope, thus, NPEF was appropriately compensated to provide accurate PEF with mean relative error less than only 1%. The 99% confidence interval of the mean relative error was less than a half of the error limit of 5% recommended by ATS. Therefore, PEF can be very accurately determined by compensating the transducer output based on the initial slope, which should be a useful technique for air flow transducer calibration.

Change in peak expiratory flow rate after the head-tilt/chin-lift maneuver among young, healthy, and conscious volunteers

조시온,이재백,진영호,정태오,윤재철,박보영 대한응급의학회 2019 Clinical and Experimental Emergency Medicine Vol.6 No.1

Objective The head-tilt/chin-lift (HT/CL) is a simple, routinely used maneuver to open the upper airway. Changes in the peak expiratory flow rate (PEFR) before and after the HT/CL maneuver have not been evaluated among conscious volunteers who are regarded as a control cohort. 'Methods Sixty healthy 20-year-old volunteers (30 males and 30 females) were enrolled. The supine position was defined as the position at which the ear-eye line was at a 10° angle to the horizontal. The HT/CL position was defined as the position at which the ear-eye line was at a 25° angle to the horizontal. PEFR was measured using a hand-held device with the subject in the supine position (pre-PEFR) and HT/CL position (post-PEFR), respectively. One set was defined as these two measurements. Five sets of measurements were performed on each subject (300 sets). The set with the maximal and minimal difference between pre-PEFR and post-PEFR were excluded from the analysis. We used a paired t-test to compare the mean pre-PEFR and post-PEFR values for the entire group and subgroups divided by sex, height, body weight, body mass index and response status. Results Overall, 360 measurements (180 sets) were analyzed. The mean pre-PEFR and post-PEFR were 316.1±87.6 and 346.5±94.7 L/min, respectively. Further, significant differences were observed for sex, height, body weight, and body mass index. In 10 subjects, post-PEFR was lower than pre-PEFR. Conclusion PEFR increased by 9.6% after the HT/CL maneuver in young conscious subjects, but some subjects showed decreased PEFR after the HT/CL maneuver.

아토피피부염 환아에서 측정한 최대호기속도에 대한 연구

박석원(Seok Won Park),조희숙(Hee Suk Cho),최원규(Won Kyu Choi),김황민(Hwang Min Kim),임백근(Baek Keun Lim),김종수(Jong Soo Kim) 대한천식알레르기학회 2001 천식 및 알레르기 Vol.21 No.1

Background and objective: There is a common progression known as the allergic march from atopic dermatitis to allergic asthma. There are many risk factors affecting allergic march such as expanded exposure to multi-allergens, family history of atopy and other environmental factors etc. In this study, we tried to check PEFR in atopic dermatitis children before development of asthma and to determine whether the PEFR can be a predicting factor of asthma. Methods : Nineteen atopic dermatitis children(group A), 21 atopic dermatitis children with asthma(group B) and 25 control children were enrolled in this study. We checked the PEFR in each subject and calculated the % predicted value. We compared the value of PEFR in each group. Results : Males were predominant in all study groups and the mean ages of the subjects were 5.9 years in group A, 6.8 years in group B, and 8.7 years in control group. The % predicted values of PEFR were 86.57±7.32 in group A, 88.16±10.33 in group B, and 100.68±17.56 in control group. There was a significant difference of PEFR between group A and control group. Additionally, the PEFR in house dust mite sensitive group was lower than that of house dust mite allergen insensitive group among atopic dermatitis group. Conclusion : The lower value of PEFR in atopic dermatitis group suggests that there is some degree of pulmonary obstruction, even if bronchial asthma does not occur. Therefore, the PEFR of atopic dermatitis can be a predicting factor for the development of asthma. (J Asthma Allergy Clin Immunol 21: 50-56, 2001)

Impact of Grilling Meat or Fish at Home on Peak Expiratory Flow Rate in Adults With Asthma

윤호주 대한천식알레르기학회 2020 Allergy, Asthma & Immunology Research Vol.12 No.4

Grilling, a common cooking method worldwide, can produce more toxic gases than other cooking methods. However, the impact of frequently grilling meat or fish at home on airflow limitation in adult asthma has not been well elucidated. We performed a prospective cohort study of 91 adult patients with asthma enrolled from 2 university hospitals. Of the patients, 39 (42.9%) grilled meat or fish at least once a week and 52 (57.1%) less than once a week. Patients who grilled at least once a week tended to have lower peak expiratory flow rate (PEFR) than those who grilled less than once a week (median, 345.5 L/min; 95% confidence interval [CI], 291.8–423.2 L/min vs. median, 375.1 L/min; 95% CI, 319.7–485.7 L/min; P = 0.059). Among patients with severe asthma who received step 4–5 treatment, PEFR was significantly lower in patients who grilled at least once a week compared with those who grilled less than once a week (median, 297.8 L/min; 95% CI, 211.3–357.7 L/min vs. median, 396.1 L/min; 95% CI, 355.0–489.6 L/min; P < 0.001). Our results suggest that the frequency of grilling meat or fish at home may affect PEFR in asthmati

Peak Voluntary Cough Flow and Oropharyngeal Dysphagia as Risk Factors for Pneumonia

Jayoon Choi,Sora Baek,Gowun Kim,Hee-won Park 대한재활의학회 2021 Annals of Rehabilitation Medicine Vol.45 No.6

Objective To investigate the relationship between voluntary peak cough flow (PCF), oropharyngeal dysphagia, and pneumonia in patients who were evaluated with videofluoroscopic swallowing study (VFSS).Methods Patients who underwent both VFSS and PCF measurement on the same day were enrolled retrospectively (n=821). Pneumonia (n=138) and control (n=683) groups were assigned based on presence of pneumonia within 1 month from the date of VFSS assessment. In addition, sex, age (<65 and ≥65 years), preceding conditions, modified Barthel Index (MBI), Mini-Mental State Examination (MMSE), PCF value (<160, ≥160 and <270, and ≥270 L/min), and presence of aspiration/penetration on VFSS were reviewed. Results Pneumonia group was more likely to be male (n=108; 78.3%), ≥65 years (n=121; 87.7%), with neurodegenerative (n=25; 18.1%) or other miscellaneous diseases (n=50; 36.2%), and in poor functional level with lower value of MBI (39.1±26.59). However, MMSE was not significantly different in comparison to that of the control group. The pneumonia group was also more likely to have dysphagia (82.6%) and lower value of PCF (<160 L/min, 70.3%). In multivariable logistic regression analysis, male sex (odd ratio [OR]=6.62; 95% confidence interval [CI], 2.70–16.26), other miscellaneous diseases as preceding conditions (OR=2.52; 95% CI, 1.14–5.58), dysphagia (OR=3.82; 95% CI, 1.42–10.23), and PCF <160 L/min (OR=14.34; 95% CI, 1.84–111.60) were factors significantly related with pneumonia.Conclusion Impaired swallowing and coughing function showed an independent association with the development of pneumonia. Patients with PCF <160 L/min require more attention with lung care and should be encouraged with voluntary coughing strategy to prevent possible pulmonary complications.

천식환자 및 만성 폐쇄성 폐질환환자군에서 연간 최대 호기유속의 변화량

홍성철 ( Sung Chul Hong ),이초이 ( Choi Lee ),한장수 ( Jang Soo Han ),김원동 ( Won Dong Kim ),이계영 ( Kye Young Lee ),김순종 ( Sun Jong Kim ),김희정 ( Hee Joung Kim ),하경원 ( Kyoung Won Ha ),전규락 ( Gyu Rak Chon ),유광하 ( Kwan 대한결핵 및 호흡기학회 2012 Tuberculosis and Respiratory Diseases Vol.72 No.1

Measurement of peak expiratory flow rate (PEFR) in a follow-up examination for a chronic airway disease is useful because it has the advantages of being a simple measurement and can be repeated during examination. The aim of this study was to examine the annual decrease of PEFR in asthma and chronic obstructive pulmonary disease (COPD) patients and to confirm the factors which influence this decrease. From May, 2003 to September, 2010, the annual decrease of PEFR was obtained from asthma and COPD patients attending an outpatient pulmonary clinic. PEFR was measured using a Mini-Wright peak flow meter (Clement Clarke International Ltd. UK), and we conducted an analysis of factors that influence the change of PEFR and its average values. The results showed an annual decrease of 1.70±12.86 L/min the asthmatic patients and an annual decrease of 10.3±7.32 L/min in the COPD patients. Age and FEV1 were the predictive factors influencing change in asthma, and FEV1 and smoking were the predictive factors influencing change in COPD. Conclusion: We confirmed the annual decreasing PEFR in patients with chronic airway disease and identified factors that work in conjunction with FEV1 to influence the change.

무증상기의 소아 천식 환자에서 최대호기속도의 일중 변동치에 대한 연구

임휘규 ( Hwi Kyu Im ),한병무 ( Byung Mu Han ),박석원 ( Seok Won Park ),김종수 ( Jong Soo Kim ) 대한 소아알레르기 호흡기학회(구 대한소아알레르기 및 호흡기학회) 2003 소아알레르기 및 호흡기학회지 Vol.13 No.2

Lung Function of Grain Millers Exposed to Grain Dust and Diesel Exhaust in Two Food Markets in Ibadan Metropolis, Nigeria

Kemi Iyogun,Suraju A. Lateef,Godson R.E.E. Ana 한국산업안전보건공단 산업안전보건연구원 2019 Safety and health at work Vol.10 No.1

Background: Despite growing concern over occupational exposure to particulate matter (PM) such as grain dust and diesel exhaust, information about the exposure level and health implications among workers in small-scale milling enterprises in developing countries like Nigeria has not been adequately documented. The purpose of this study was to assess the level of exposure to grain dust and diesel exhaust and effect on lung function among grain millers in food markets in Ibadan metropolis, Nigeria. Methods: The study adopted descriptive cross-sectional design with a comparative approach. Sixteen grain milling shops each were randomly selected from two major food markets in Ibadan metropolis for indoor PM10 and PM2.5 monitoring. Seventy-two respondents each were proportionately selected from grain millers and shop owners for forced expiratory volume in one second and peak expiratory flow rate tests. Results: The PM2.5 concentrations for both market locations ranged between 1,269.3 and 651.7 mg/m3, while PM10 concentrations were between 1,048.2 and 818.1 mg/m3. The recorded concentrations exceeded the World Health Organization guideline limit of 50 mg/m3 and 25 mg/m3 for PM2.5 and PM10, respectively. As compared with control group (2.1 L), significantly lower forced expiratory volume in one second value (1.61 L) was observed among the exposed group (p < 0.05). Likewise, significantly lower peak expiratory flow rate value (186.7 L/min) was recorded among the exposed group than the control group (269.51 L/min) (p < 0.05). Conclusion: Exposure to grain dust and diesel exhaust accentuated respiratory disorders with declines in lung functions amongst grain millers. Improved milling practices and engaging cleaner milling facilities should be adopted to minimize exposure and related hazards.

Lung Function of Grain Millers Exposed to Grain Dust and Diesel Exhaust in Two Food Markets in Ibadan Metropolis, Nigeria

Iyogun, Kemi,Lateef, Suraju A.,Ana, Godson R.E.E. Occupational Safety and Health Research Institute 2019 Safety and health at work Vol.10 No.1

Background: Despite growing concern over occupational exposure to particulate matter (PM) such as grain dust and diesel exhaust, information about the exposure level and health implications among workers in small-scale milling enterprises in developing countries like Nigeria has not been adequately documented. The purpose of this study was to assess the level of exposure to grain dust and diesel exhaust and effect on lung function among grain millers in food markets in Ibadan metropolis, Nigeria. Methods: The study adopted descriptive cross-sectional design with a comparative approach. Sixteen grain milling shops each were randomly selected from two major food markets in Ibadan metropolis for indoor $PM_{10}$ and $PM_{2.5}$ monitoring. Seventy-two respondents each were proportionately selected from grain millers and shop owners for forced expiratory volume in one second and peak expiratory flow rate tests. Results: The $PM_{2.5}$ concentrations for both market locations ranged between 1,269.3 and $651.7{\mu}g/m^3$, while $PM_{10}$ concentrations were between 1,048.2 and $818.1{\mu}g/m^3$. The recorded concentrations exceeded the World Health Organization guideline limit of $50{\mu}g/m^3$ and $25{\mu}g/m^3$ for $PM_{2.5}$ and $PM_{10}$, respectively. As compared with control group (2.1 L), significantly lower forced expiratory volume in one second value (1.61 L) was observed among the exposed group (p < 0.05). Likewise, significantly lower peak expiratory flow rate value (186.7 L/min) was recorded among the exposed group than the control group (269.51 L/min) (p < 0.05). Conclusion: Exposure to grain dust and diesel exhaust accentuated respiratory disorders with declines in lung functions amongst grain millers. Improved milling practices and engaging cleaner milling facilities should be adopted to minimize exposure and related hazards.