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Peak flow help

With COPD, why are the PEFR readings stable, but fluctuating with asthma? I thought they'd fluctuate in COPD too
They will change in COPD a bit - I'd expect it to be worse during an exacerbation. But exacerbations aside COPD is more of a chronic, degenerative process whereas just day to day in asthma you'd expect variation as airways narrow and widen depending on different factors.

Asthma can be variable too though - there's definitely a difference between someone with classic allergic asthma with high eosinophils and someone with low eosinophils and a more chronic disease. I don't think we know how to treat the two differently yet though, so its not reflected in treatment guidance.
As above, there will always be a natural variation along a baseline, however this is more marked in asthma. The textbooks describe asthma as having a diurnal variation, thought to be associated with the normal circadian/endocrine rhythm. This isn't observed quite as much in COPD patients.
(edited 5 years ago)

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