The Impact of Peak Expiratory Flow Variability on the Forced Expiratory Volume in 1 Second

作者：Jake Williams, Abdul Yakubu, Ben Knox‐Brown, Josh Barnes, Karl Sylvester · 年份：2025 · DOI：10.1183/13993003.congress-2025.pa635 · 研究领域：Chronic Obstructive Pulmonary Disease (COPD) Research、Inhalation and Respiratory Drug Delivery、Asthma and respiratory diseases

Introduction Current ARTP guidelines suggest that Peak Expiratory Flow (PEF) variability between spirometry manoeuvres should be within 40 L.min -1 to meet acceptability criteria. However, evidence to support this recommendation is lacking. Therefore, this study aimed to assess the impact of PEF variability on FEV 1 reproducibility in a cohort with diverse respiratory conditions. Methodology 22,071 spirometry manoeuvres from 4,913 patients (55% male; median age 64) in 2023 were analysed. To assess PEF’s impact on FEV 1 , we compared manoeuvres from the same session compliant with ATS/ERS standards to a reference manoeuvre with the highest PEF. Data was stratified by airflow obstruction (FEV 1 /FVC <LLN) and non-obstruction (FEV 1 /FVC ≥LLN). We examined FEV 1 differences across five PEF difference categories, ranging from ≤40 L.min -1 to >200 L.min -1 . Results A significant difference in FEV 1 across all PEF categories (p < 0.001). As PEF difference increased, the FEV 1 difference also increased, with a more pronounced effect in obstructed patients (Figure 1). Conclusion This study show that PEF reproducibility is directly related to FEV 1 reproducibility, especially in patients with airflow obstruction. Our results support the current ARTP criteria that the PEF of acceptable spirometry manoeuvres should be within 40 L.min -1 of each other. Larger variation can result in upwards of 25% of manoeuvres having an FEV 1 difference >150ml. erj;66/suppl_69/PA635/F...