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. 2022 Feb;279(2):1099-1104.
doi: 10.1007/s00405-021-07066-z. Epub 2021 Sep 2.

Assessment of peak inspiratory flow in the management of acute inspiratory dyspnoea

Emeline Drapier  1 , Esteban Brenet  1 , Marie-Anne Louges  1 , Jean-Claude Merol  1 , Marc Labrousse  1 , Xavier Dubernard  2
Affiliations

Assessment of peak inspiratory flow in the management of acute inspiratory dyspnoea

Emeline Drapier et al. Eur Arch Otorhinolaryngol. 2022 Feb.

Abstract

Purpose: Assessment of inspiratory dyspnoea associated with upper airway obstruction is based on subjective clinical and nasal fibreoptic laryngoscopy (NFL) signs. The aim of this study was to determine whether peak inspiratory flow (PIF) measurement could indicate the need for upper airway release surgery in patients with acute inspiratory dyspnoea during emergency.

Methods: A retrospective single-institution study (February 2018-March 2020) of 48 patients with acute inspiratory dyspnoea and PIF measurement (Peak Flow In-Check Dial G16®-Harlow-England) was conducted. The surgical decision was based on the clinical evaluation of the patient's respiratory tolerance and NFL.

Results: Forty-eight patients were included in this study. Thirty-five patients underwent surgery (PIF: 36 L/min), and 13 patients did not (PIF: 58 L/min) (p = 0.0009). Three of these 13 patients underwent an operation later (PIF value: 42 L/min versus 63 L/min for the 10 others [p = 0.25]).

Conclusion: PIF measurement is a quantitative, objective, inexpensive, non-invasive, and quick test that is potentially useful for general practitioners, mobile medical teams, or for ear-nose-and-throat specialists. A threshold of 42 L/min can help doctors in emergency decision making to refer patients to an ear-nose-and-throat specialist to release the upper airway and perform surgery or to choose medical monitoring for patients with emergency inspiratory dyspnoea.

Keywords: Acute inspiratory dyspnoea; Peak inspiratory flow; Respiratory distress; Tracheotomy; Upper airway obstruction.

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