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

H Fitzgerald; B Kennedy; D A Fitzgerald; H Selvadurai

doi:10.1016/j.prrv.2024.04.001

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

Paediatr Respir Rev. 2024 Sep:51:26-31. doi: 10.1016/j.prrv.2024.04.001. Epub 2024 Apr 4.

Authors

H Fitzgerald¹, B Kennedy², D A Fitzgerald³, H Selvadurai³

Affiliations

¹ Department of Respiratory Medicine, The Children's Hospital at Westmead, Westmead, Sydney, NSW, 2145, Australia. Electronic address: hugh.fitzgerald@health.nsw.gov.au.
² Department of Respiratory Medicine, The Children's Hospital at Westmead, Westmead, Sydney, NSW, 2145, Australia.
³ Department of Respiratory Medicine, The Children's Hospital at Westmead, Westmead, Sydney, NSW, 2145, Australia; Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney, Camperdown, Sydney, NSW, 2006, Australia.

PMID: 38616459
DOI: 10.1016/j.prrv.2024.04.001

Abstract

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 Box^TM, Ultrasonic flow meter-based, or Vyaire Pneumotachograph^TM, 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.

Keywords: Children; Neuromuscular Disorders; Peak Cough Flow; Peak Expiratory Flow; Spirometry.

Publication types

Comparative Study

MeSH terms

Adolescent
Child
Cough* / physiopathology
Female
Humans
Male
Neuromuscular Diseases* / physiopathology
Peak Expiratory Flow Rate / physiology
Reproducibility of Results
Spirometry* / statistics & numerical data
Young Adult