PT  - JOURNAL ARTICLE
AU  - Jessica L Wallace
AU  - Christa M George
AU  - Elizabeth A Tolley
AU  - John C Winton
AU  - Dana Fasanella
AU  - Christopher K Finch
AU  - Timothy H Self
TI  - Peak Expiratory Flow in Bed? A Comparison of 3 Positions
AID  - 10.4187/respcare.01843
DP  - 2013 Mar 01
TA  - Respiratory Care
PG  - 494--497
VI  - 58
IP  - 3
4099  - http://rc.rcjournal.com/content/58/3/494.short
4100  - http://rc.rcjournal.com/content/58/3/494.full
AB  - BACKGROUND: Current guidelines for the correct peak expiratory flow (PEF) maneuver include standing. In the hospital setting, PEF values are often ordered to assess response to asthma therapy for exacerbations. We have observed that the PEF is sometimes performed with the patient in bed. METHODS: Healthy adults performed the PEF maneuver in random order, standing, lying back at an ∼45° angle on pillows, and sitting, slumped forward ∼10° with legs extended. PEF was recorded for 3 attempts in each of the 3 positions. RESULTS: We enrolled 94 subjects (39 male, 55 female, mean age 24 y) in 2011. Mean PEF in the standing position (669 ± 42 L/min) was significantly higher than in the lying back (621 ± 42 L/min) (P < .001) and sitting (615 ± 42 L/min) positions in males (P < .001), and, similarly, in females, standing produced a significantly higher mean PEF (462 ± 42 L/min) than the lying back (422 ± 42 L/min) (P < .001) and sitting (447 ± 42 L/min) positions (P < .05). CONCLUSIONS: Clinicians should ensure that PEF is obtained with patients out of bed and in the standing position.