A comparison of peak cough flow and peak expiratory flow in children with neuromuscular disorders

• Published in: Paediatric respiratory reviews Vol. 51; pp. 26 - 31
• Main Authors: Fitzgerald, H., Kennedy, B., Fitzgerald, D.A., Selvadurai, H.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2024
• Subjects: Adolescent; Child; Children; Cough - physiopathology; Female; Humans; Male; Neuromuscular Diseases - physiopathology; Neuromuscular Disorders; Peak Cough Flow; Peak Expiratory Flow; Peak Expiratory Flow Rate - physiology; Reproducibility of Results; Spirometry; Spirometry - statistics & numerical data; Young Adult; Spirometry; Children; Peak Expiratory Flow; Neuromuscular Disorders; Peak Cough Flow
• ISSN: 1526-0542; 1526-0550; 1526-0550
• DOI: 10.1016/j.prrv.2024.04.001

The reader will come to appreciate the:•Excellent correlation between peak cough flow [PCF] and peak expiratory flow derived from using the same spirometer.•Benefits of repeated testing to achieve reproducible spirometry to better inform and guide clinical care.•PCF testing can be utilised for children where performing technically acceptable spirometry is not possible. Spirometry and peak cough flow testing (PCF) are commonly used in the respiratory assessment of children with a neuromuscular disorder (NMD). Testing uses two different machines, increases laboratory time, costs and resource utilisation. No studies have assessed the correlation between peak expiratory flow (PEF) obtained from spirometry and PCF in children with NMD using one device. An audit of children with a NMD managed at the Children’s Hospital at Westmead in 2022–2024 aged < 20 years who performed spirometry and PCF testing on the same device (Vyaire Body BoxTM, Ultrasonic flow meter-based, or Vyaire PneumotachographTM, Pneumotach flow meter-based; Germany) was conducted to assess the correlation between PCF and PEF. Fifty-one sets of testing were identified, and 40 subjects (9F) had reproducible testing and were included. Median (range) age was 14.95 (7.20–19.00) years. Median PEF (L/min) was 4.05 (1.22–10.26) and median PCF (L/min) was 4.29 (1.69–10.82). PEF and PCF had a strong Pearson’s correlation coefficient, (R = 0.97, p = 0.03). The coefficient of determination was 0.93. If laboratory resources permit, spirometry should be the test of choice for children with NMD. On average, spirometry required multiple practices to achieve reproducibility to meet ATS/ERS standards. PCF testing can be utilised for children where performing technically acceptable spirometry is not possible.