WordNet

be worthy of or have a certain rating; "This bond rates highly"
amount of a charge or payment relative to some basis; "a 10-minute phone call at that rate would cost $5" (同)charge per unit
a magnitude or frequency relative to a time unit; "they traveled at a rate of 55 miles per hour"; "the rate of change was faster than expected"
a quantity or amount or measure considered as a proportion of another quantity or amount or measure; "the literacy rate"; "the retention rate"; "the dropout rate"
assign a rank or rating to; "how would you rank these students?"; "The restaurant is rated highly in the food guide" (同)rank, range, order, grade, place
estimate the value of; "How would you rate his chances to become President?"; "Gold was rated highly among the Romans" (同)value
cause to flow; "The artist flowed the washes on the paper"
the amount of fluid that flows in a given time (同)flow_rate, rate of flow
any uninterrupted stream or discharge
cover or swamp with water
the act of flowing or streaming; continuous progression (同)stream
the motion characteristic of fluids (liquids or gases) (同)flowing
move or progress freely as if in a stream; "The crowd flowed out of the stadium" (同)flux
be abundantly present; "The champagne flowed at the wedding"
give (hair) the appearance of being fuller by using a rat
a pad (usually made of hair) worn as part of a womans coiffure
any of various long-tailed rodents similar to but larger than a mouse
catch rats, especially with dogs
desert ones party or group of friends, for example, for ones personal advantage
employ scabs or strike breakers in
the top or extreme point of something (usually a mountain or hill); "the view from the peak was magnificent"; "they clambered to the tip of Monadnock"; "the region is a few molecules wide at the summit" (同)crown, crest, top, tip, summit
a leguminous plant of the genus Pisum with small white flowers and long green pods containing edible green seeds (同)pea plant
the fruit or seed of a pea plant
seed of a pea plant used for food

PrepTutorEJDIC

〈C〉『割合』,『率』 / 〈C〉《the~,a~》『速度』(speed),進度 / 〈C〉『値段』,『相場』;料金 / 〈U〉等級(class),(…)等 / 《複数形ぃ》《英》地方税 / (…の金額に)…‘の'『値段を決める』,見積もる《+『名』+『at』+『名』》 / …‘を'『評価する』,みなす / 《米話》…‘に'値する,‘の'価値がある / 『評価される』;みなされる
…‘を'どなりつける
《副詞巳句始を伴って》〈気体・液体・電気などが〉『流れる』 / 《副詞[句]を伴って》〈言葉・人々などず〉流れるように続く / 〈心・場所などが〉(…で)いっぱいになる,満ちあふれる《+『with』+『名』》 / 《副詞[句]を伴って》〈髪・服などが〉長く垂れる;風になびく / 〈潮が〉満ちる / (…から)生じる,発生する《+『from』+『名』》 / 〈C〉《単数形で》(気体・液体・電気などの)『流れ』《+『of』+『名』》 / 〈C〉《単数形で》(言葉・人などの)絶え間のない(よどみのない)流れ《+『of』+『名』》 / 〈C〉《単数形で》(…の)洪水,はんらん《+『of』+『名』》 / 〈U〉《the flow》満ち潮,上げ潮
『ネズミ』 / ひきょう者,裏切り者 / ネズミをつかまえる / 《話》(人を)裏切る,密告する《+『on』+『名』〈人〉》
(とがった)『山頂』,峰;最も高い所 / (独立した)鋭峰,孤峰 / 『とがった先』,先端 / (事の)最頂点,絶頂,ピーク / (帽子の)前びさし / 最高の,最大の,ピークの / 頂点に達する,最高(最大)になる
《古》〈勢いが〉衰える;〈人が〉病み衰える,やつれる
『エンドウ』;エンドウ豆

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/02/04 20:38:12」(JST)

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[Wiki en表示]

The peak expiratory flow (PEF), also called peak expiratory flow rate (PEFR) is a person's maximum speed of expiration, as measured with a peak flow meter, a small, hand-held device used to monitor a person's ability to breathe out air. It measures the airflow through the bronchi and thus the degree of obstruction in the airways.

Function

Peak flow readings are higher when patients are well, and lower when the airways are constricted. From changes in recorded values, patients and doctors may determine lung functionality, the severity of asthma symptoms, and treatment.

The first measure of precaution would be to check patient for signs and symptoms of asthmatic hypervolemia. This would indicate whether or not to even continue with the Peak Flow Meter procedure. Measurement of PEFR requires training to correctly use a meter and the normal expected value depends on a patient's sex, age, and height. It is classically reduced in obstructive lung disorders such as asthma.

Due to the wide range of 'normal' values and the high degree of variability, peak flow is not the recommended test to identify asthma. However, it can be useful in some circumstances.

A small portion of people with asthma may benefit from regular peak flow monitoring. When monitoring is recommended, it is usually done in addition to reviewing asthma symptoms and frequency of reliever medication use.^[1]

When peak flow is being monitored regularly, the results may be recorded on a peak flow chart.

It is important to use the same peak flow meter every time.

Scales or Reference Values

Normal values, shown on EU scale.^[2]

This peak flow meter uses the EU scale.

To interpret the significance of peak expiratory flow measurements, a comparison is made to reference (normal, predicted) values based on measurements taken from the general population. Various reference values have been published in the literature and vary by population, ethnic group, age, sex, height and weight of the patient. For this reason, tables or charts are used to determine the normal value for a particular individual. More recently, medical calculators have been developed to calculate predicted values for peak expiratory flow. There are a number of non-equivalent scales used in the interpretation of peak expiratory flow.^[3]

Some examples of Reference Values are given below. There is a wide natural variation in results from healthy test subjects.

Wright scale^[4]^[5]
EN 13826 or EU scale^[6]
NHANESIII^[7] reference values provided by the US Centers for Disease Control (CDC)

In 2004 the UK switched from the original Wright scale to the newer, more accurate European scale. Wright values may be converted to the EU scale using the following formula:^[8]

The reverse calculation is:

Where is the value in the Wright scale.

These formulas have also been trended over time in both rural and metropolitan areas both as air quality studies and as studies on asthma due to the Peak Flow measurement's accuracy as a predictor of mortality and poor prognosis.^[9]

Measurement

The highest of three readings is used as the recorded value of the Peak Expiratory Flow Rate. It may be plotted out on graph paper charts together with a record of symptoms or using peak flow charting software. This allows patients to self-monitor and pass information back to their doctor or nurse.^[10]

Peak flow readings are often classified into 3 zones of measurement according to the American Lung Association;^[11] green, yellow, and red. Doctors and health practitioners can develop an asthma management plan based on the green-yellow-red zones.

Zone	Reading	Description
Green Zone	80 to 100 percent of the usual or normal peak flow readings are clear.	A peak flow reading in the green zone indicates that the asthma is under good control.
Yellow Zone	50 to 79 percent of the usual or normal peak flow readings	Indicates caution. It may mean respiratory airways are narrowing and additional medication may be required.
Red Zone	Less than 50 percent of the usual or normal peak flow readings	Indicates a medical emergency. Severe airway narrowing may be occurring and immediate action needs to be taken. This would usually involve contacting a doctor or hospital.

History

The measurement of peak expiratory flow was pioneered by Martin Wright, who produced the first meter specifically designed to measure this index of lung function. Since the original design of instrument was introduced in the late 1950s, and the subsequent development of a more portable, lower cost version (the "Mini-Wright" peak flow meter), other designs and copies have become available across the world.^[12]

References

^ National Asthma Council of Australia
^ Nunn, A. J., and I. Gregg. 1989. New regression equations for predicting peak expiratory flow in adults. Br. Med. J. 298: 1068-1070. Adapted by Clement Clarke for use in EU scale - see Peakflow.com > Predictive Normal Values (Nomogram, EU scale)
^ Martin R. Miller (June 2004). "Peak expiratory flow meter scale changes: implications for patients and health professionals" (PDF). The Airways Journal 2 (2): 80. Retrieved 2006-06-06.
^ Nunn A, Gregg I (1989). "New regression equations for predicting peak expiratory flow in adults". BMJ 298 (6680): 1068–70. doi:10.1136/bmj.298.6680.1068. PMC 1836460. PMID 2497892. - Predicted peak expiratory flow in normal adults using Wright-scale
^ Godfrey S, Kamburoff PL, Naim JL (1970). "Spirometry, lung volumes and airway resistance in normal children ages 5 to 18". Br J Dis Chest 64 (1): 15–24. doi:10.1016/S0007-0971(70)80045-6. PMID 5438753. - Predicted peak expiratory flow in normal children using Wright-scale
^ Clement Clarke International (2004). "Predictive Normal Values (Nomogram, EU scale)". Clement Clarke International. Retrieved 2006-06-06. - Downloadable PDF charts for adults and children using EU scale
^ J.L. Hankinson, J.R. Odencrantz, and K.B. Fedan, Spirometric Reference Values from a Sample of the General U.S. Population. Am J Respir Crit Care Med, Vol 159, pp. 179-187, 1999.
^ Clement Clarke International (2004). "Mini-Wright Peak Flow Meter - Wright to EU (EN13826) converter". Clement Clarke International. Archived from the original (EXE macromedia flash) on September 30, 2007. Retrieved 2006-06-06.
^ Knudson, RJ (1983). "Changes in the normal maximal expiratory flow-volume curve with growth and aging.". Am Rev Respir Dis. 27 (6): 725–34. PMID 6859656.
^ Scottish Intercollegiate Guidelines Network & The British Thoracic Society (July 2007). "British Guideline on the Management of Asthma - Annex 8: Personal Asthma Action Plan" (PDF). Thorax 58: Suppl I. doi:10.1136/thx.58.suppl_1.i83. Retrieved 2011-10-27. - for recording chart of PEFR readings
^ American Lung Association. "How can I determine a normal peak flow rate for me?".
^ WRIGHT BM, McKERROW CB (November 1959). "Maximum forced expiratory flow rate as a measure of ventilatory capacity: with a description of a new portable instrument for measuring it". Br Med J 2 (5159): 1041–6. doi:10.1136/bmj.2.5159.1041. PMC 1990874. PMID 13846051. Retrieved 2014-06-02.

External Links

National Asthma Council of Australia
Estimated Peak Expiratory Flow Calculator
NHANES III predicted value calculator for Peak Expiratory Flow

UpToDate Contents

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1. 喘息における最大呼気流速度モニタリング peak expiratory flow rate monitoring in asthma
2. 計算機：最大呼気流量（PEF）の予測 calculator peak expiratory flow prediction
3. 小児における肺機能検査の概要 overview of pulmonary function testing in children
4. 思春期および成人における喘息の診断 diagnosis of asthma in adolescents and adults
5. 成人における喘息の急性増悪の治療 treatment of acute exacerbations of asthma in adults

English Journal

Advanced Mechanical Ventilatory Constraints During Incremental Exercise in Class III Obese Male Subjects.

Chlif M1, Temfemo A2, Keochkerian D2, Choquet D3, Chaouachi A4, Ahmaidi S2.
Respiratory care.Respir Care.2015 Jan 27. pii: respcare.03206. [Epub ahead of print]
BACKGROUND: We investigated the role of mechanical ventilatory constraints in obese class III subjects during incremental exercise.METHODS: We examined 14 control subjects (body mass index [BMI], 23.6 ± 3.2 kg/m2), 15 obese class II subjects (BMI, 37.2 ± 4.5 kg/m2), and 17 obese class III subjects
PMID 25628449

Performance characteristics of seven bilevel mechanical ventilators in pressure-support mode with different cycling criteria: a comparative bench study.

Chen Y1, Cheng K2, Zhou X1.
Medical science monitor : international medical journal of experimental and clinical research.Med Sci Monit.2015 Jan 26;21:310-7. doi: 10.12659/MSM.892080.
Background Pressure support ventilation from a bilevel device is a standard technique for non-invasive home ventilation. A bench study was designed to compare the performance and patient-ventilator synchronization of 7 bilevel ventilators, in the presence of system leaks. Material and Methods Ventil
PMID 25619202

The effect of mechanical ventilator settings during ventilator hyperinflation techniques: a bench-top analysis.

Thomas PJ1.
Anaesthesia and intensive care.Anaesth Intensive Care.2015 Jan;43(1):81-7.
Ventilator hyperinflations are used by physiotherapists for the purpose of airway clearance in intensive care. There is limited data to guide the selection of mechanical ventilator modes and settings that may achieve desired flow patterns for ventilator hyperinflation. A mechanical ventilator was co
PMID 25579293

Japanese Journal

Stratifying a Risk for an Increased Variation of Airway Caliber among the Clinically Stable Asthma

Hayata Atsushi,Matsunaga Kazuto,Hirano Tsunahiko,Akamatsu Keiichiro,Ichikawa Tomohiro,Minakata Yoshiaki,Ichinose Masakazu
Allergology International 62(3), 343-349, 2013
… Background: Recently, correlations of peak expiratory flow (PEF) variation have been shown to facilitate the prediction of later asthma symptoms and exacerbations. … ACQ, forced expiratory volume in 1 s % of predicted (%FEV1), and FENO were identified as independent predictors of Min%Max < …
NAID 130004477196

Successful Treatment with Noninvasive Positive-pressure Ventilation Based on the Prediction of Disease Onset Using CT and Respiratory Function Tests in an Elderly Patient with Relapsing Polychondritis

Yamaguchi Hiromichi,Komase Yuko,Ono Ayami,Morita Akane,Ishida Akira
Internal Medicine 52(10), 1085-1089, 2013
… Measuring the peak expiratory flow rate was useful in the early airway assessment. …
NAID 130003365596

北海道における気管支喘息児のコントロール状態と家庭での自己管理との関連性

細野恵子,Keiko HOSONO
紀要 6, 39-47, 2012-03
気管支喘息と診断され通院する北海道在住の小児と保護者を対象に,喘息コントロール状態をJapanesePediatric Asthma Control Program:JPAC で評価し自己管理との関連を分析し,看護支援の課題検討を目的に自作の自記式質問紙により2010 年2 〜 4 月に調査を実施した。有効回答403 部を分析対象に評価すると,喘息コントロール状態は「完全コントロール群」24.8% …
NAID 110009428353