They are also considered normal when the forced vital capacity, or FVC, to FEV1 ratio is 0.7 or less, says Patient. The average total lung capacity of an adult human male is about 6 litres of air.. Average FEV1 values between 80% and 120% are considered as normal. Forced expiratory volume in 1 second (FEV1) FEV1 is the volume of air that can forcibly be blown out in first 1 second, after full inspiration. BibTeX (win & mac)Download; EndNote (tagged)Download; Objectives: Forced expiratory volume in 1 (FEV1) second is known as the amount of air volume that can forcibly be blown out in one second, after full inspiration. The relationship between expiratory time constant (RC EXP) and forced expiratory volume in 1 s/forced vital capacity (FEV 1 /FVC). Forced vital capacity. 11 Slowing of the expiratory flow that results from air-flow obstruction induces a concave shape in the maximum expiratory flow-volume curve during forced exhalation. Lung volumes and lung capacities refer to the volume of air in the lungs at different phases of the respiratory cycle.. Spirometry demonstrated a ratio of forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) of 0.39, FEV1 of 1.01 L (39% of predicted value) and FVC of 2.58 L (81% of predicted value), consistent with severe airflow obstruction. FEV1% (FER) Forced expiratory ratio (FEV1/FVC)x100: Percentage of FVC expelled in the first second of a forced expiration. Eurasian J Pulmonol [serial online] 2019 [cited 2021 May 26];21:175-81. Charts which allow the ready determination of these values have been presented. Under normal conditions, the forced expiratory volume is normally _____. It's used as a common indexes in the diagnosis of airway obstructive and restrictive lung disease. A. Pulmonary function tests are performed to diagnose or rule out obstructive, restrictive or mixed ventilatory defects 1.Airway obstruction is directly defined by spirometry and is characterised by the presence of a low forced expiratory volume in one second (FEV 1)/forced vital capacity (FVC) or FEV 1 /forced expiratory volume in six seconds (FEV 6) ratio 1–3. However, the EOT volume will usually meet the ATS/ERS criteria when a patient stops exhaling and does not inhale. A completely automated method of on-line computerized spirometry was used to measure the forced vital capacity, one-second forced expiratory volume, maximal expiratory flow, and maximal midexpiratory flow of 482 healthy, normal boys and 468 healthy, normal girls, aged 5 years through 18 years. How quickly you … Normal Spirometry Values of FeV are more important for assessing the lung function. The second is the forced expiratory volume-one second (FEV1). The most common spirometry measurements are peak expiratory flow (PEF), forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC). With normal lungs should expire 95 per cent of vital capacity (VC) in 1 second. Analysis of Some Data from the U.K. (FEV1.0) • FEV1.0/FVC ratio • FEF25-75% - forced expiratory flow between the 25 th and 75th percent of an exhaled breath • Peak flow rate (PEF, PEFR) – highest flow rate achieved during expiration Volume of air expelled in the first second of a forced expiration. Lung volumes are measured by a technique called spirometry . FET Forced expiratory time FEV 1 Forced expiraort y volume in 1 second FVC Forced vital capacity GLI Global Lung Function Initiative LLN Lower limit of normal for demographic group PEF Peak expiratory flow For more information, refer to the National Asthma Council Australia’s Height, weight, and ethnicity are some of the other influencing factors. An important indicator of lung function is forced expiratory volume (FEV), which is the volume of air that a person can expire in one second. FVC is the most basic maneuver in spirometry tests. Reduced in both obstructive and restrictive disease. Respirology. It is important to assess the prognosis of patients with chronic obstructive pulmonary disease (COPD) and acute exacerbation of COPD (AECOPD). 2012;17(3):402–11. The amount of air exhaled may be measured during the first (FEV1), second (FEV2), and/or third seconds (FEV3) of the forced breath. B. Forced expiratory flow 25% to 75% Inspiratory reserve volume, or IRV, is the amount of air that can be forcibly inspired after a normal _____. Inspiratory Reserve Volume (IRV) Expiratory Reserve Volume (ERV) See Figures 7.4 and 7.5 for sample graphs of these two measurements. Figure 7.5. So each question has 3 parts. In patients Age and gender are the major factors that affect the average values of FEV in healthy individuals. It is used to describe the degree of airway obstruction caused by asthma in a routine test called spirometry or pulmonary function testing, using an instrument called a spirometer. FEV1, % pred = Forced Expiratory Volume 1s (% of predicted) (%) Age = Patient Age (years) Sex = Gender (Male) Ht = Body Height (cm) (undefined, undefined) FEV1 = Forced Expiratory Volume 1s (measured) (L) ... Normal values presented here are only a general guide. What is the residual volume (RV)? – FEV 6 can be used as a measurement of FVC in adults • FEV 1: Forced expiratory volume in one second (best measure of assessing airway obstruction) Forced expiratory volume in one second (FEV1) Forced vital capacity (FVC) The ratio of the two volumes (FEV1/FVC) Spirometry and the calculation of FEV1/FVC allows the identification of obstructive or restrictive ventilatory defects. PurposeTo evaluate the concordance between the value of the actual maximum voluntary ventilation (MVV) and the estimated value by multiplying the forced expiratory volume in the first second (FEV1) and a different value established in the literature.MethodsA retrospective study was conducted with healthy subjects and patients with stable chronic obstructive pulmonary disease (COPD). Normal lungs generally can empty more than 80 percent of their volume in six seconds or less. Given differences in subject characteristics between the two samples, we hypothesized that these discrepant findings may reflect a heretofore unrecognized association between forced expiratory tracheal … In addition, doctors can measure forced expiratory volume during the second and third seconds of the FVC test. Normal ~ 0.5L Inspiratory Reserve Volume (IRV) - the volume from resting inspiration to maximal inspiration. Pisi R, Tzani P, Aiello M, Martinelli E, Marangio E, Nicolini G, Olivieri D, Chetta A Allergy Asthma Proc 2013 Jan-Feb;34(1):e14-20. FEV1 70-80% of predicted; Moderate Obstructive Lung Disease. The most widely used diagnostic application for lung capacities is the ratio between forced expiratory volume (FEV1) and forced vital capacity (FVC). The normal FVC range for an adult is between 3 liters and 5 liters. Fev1 refers to Forced Expiratory Volume. conductance (sGaw), and thoracic gas volume (TGV) (1,2). 3. 58. values of forced expiratory volume and forced inspiratory volume in one second (F.E.V.1.0, F.I.V.1.0). For some tests (for example, residual volume, forced expiratory flow at 25% to 75 % of the forced vital capacity (FEF25-75), the changes attributed to aging in adults … FEV (forced expiratory volume) measures how much air a person can exhale during a forced breath. The FEV1% is the FEV1 divided by the VC (Vital Capacity: see next spirometry test on this page) times 100: FEV1%=FEV1/VC X100. Am Rev Respir Dis, 131(4):511-520, 01 Apr 1985 Cited by: 78 articles | PMID: 3873193 inhalation. The maximum volume of air that can be expired after maximal inspiration; VC can be measured through: Slow respiratory maneuvers Reduced values indicate an obstructive lung disease , such asthma, bronchitis, or COPD (chronic obstruc-tive pulmonary disease), which block normal airflow. The value of RC EXP, which is calculated based on the effort-independent part of the MEFV curves, is closely associated with FEV 1 /FVC, with a high R 2 value of 0.8204 (P < 0.001). Forced expiratory volume in one second (FEV1) is a measurement of your ability to expel air from your lungs. Lung function tests check to see how well your lungs work. forced expiratory flows. FEV1 divided by FVC . What is vital capacity? This preview shows page 2 - 4 out of 4 pages. • Forced vital capacity (FVC) – amount of air that can be exhaled in one breath with maximum force • Forced expiratory volume in 1 sec. Forced Expiratory Volume 32. FEV1/FVC Ratio. NORMAL FLOW-VOLUME LOOP. Flow recorded as a function of volume exhaled, the flow-volume curve. 12-4). To measure forced vital capacity ( FVC) and forced expiratory volume ( FEVT ) the subject should _____. Small airways are relevant to the pathophysiology of asthma. Forced expiratory volume is measured during the forced vital capacity test. However, expiratory CT scan shows multifocal areas of air-trapping. e. forced expiratory volume. Volume of air remaining after a normal exhalation: 2.4: ERV+RV: Total lung capacity (TLC) Total volume of air in the lungs after a maximal inspiration: 6.0: RV+ERV+TV+IRV: Forced expiratory volume (FEV1) How much air can be forced out of the lungs over a specific time period, usually one second ~4.1 to 5.5 – This is a measurement of lung size (in liters) and represents the volume of air in the lungs that can be exhaled following a deep inhalation. 1 See answer When the radius of the airway was decreased, _____. Tidal volume – represents the volume of air inhaled and exhaled during one normal breathing: inhalation and exhalation. 1. 7. This value defines the amount of air exhaled (assuming maximal effort) in 0.5 seconds. Lower than predicted value . Maximum expiratory flow rates like forced expiratory volume in 1 sec ([FEV.sub.1]), [FEV.sub.1]/FVC (per cent), forced expiratory flow at 50 per cent of FVC, forced expiratory flow at 75 per cent of FVC and forced expiratory flow at 25-75 per cent of FVC were normal or near normal (Table I). Forced expiratory volume in one second (FEV1) Volume of air expelled in the first second of a forced expiration. the internal intercostals contract. This is known as the peak expiratory flow. The maximum volume of air that can be expired after maximal inspiration; VC can be measured through: Slow respiratory maneuvers It calculates the amount of air that a person can force out of their lungs in 1 second. They are also considered normal when the forced vital capacity, or FVC, to FEV1 ratio is 0.7 or less, says Patient. The FEV1/FVC ratio is the ratio of the forced expiratory volume in the first one second to the forced vital capacity of the lungs. Tidal breathing is normal, resting breathing; the tidal volume is the volume of air that is inhaled or exhaled in only a single such breath. 1 Expiratory reserve volume (ERV): It is the maximum volume of air which can be expired over and above a normal tidal expiration with a maximum expiratory effort. Average values for FEV1 in healthy people depend mainly on sex and age, according to the diagram. The volume expired during the first second of maximum expiration; FEV1/FVC – The FEV1 expressed as a percentage of the FVC. Can be as low as 42% of the individuals normal value in a high level tetraplegic. The acquired data are then used to predict FEV1. Hankinson JL, Eschenbacher B, Townsend M, et al. a. Normal values of forced vital capacity (FVC), forced expiratory volume (FEV 1-0), and peak flow rate (PFR) in children. This is the amount of air you can force out of your lungs in one second. doi: 10.2500/aap.2013.34.3641. Normal in restrictive disease - reduced in obstructive disease. Volume of air remaining after a normal exhalation: 2.4: ERV+RV: Total lung capacity (TLC) Total volume of air in the lungs after a maximal inspiration: 6.0: RV+ERV+TV+IRV: Forced expiratory volume (FEV1) How much air can be forced out of the lungs over a specific time period, usually one second ~4.1 to 5.5 – Normal; 2000 to 3200 ml. Spirometry Values • FVC: Forced vital capacity: the volume of air that can be maximally forcefully exhaled. Dockery DW, Ware JH, Ferris BG, Glicksberg DS, Fay ME, Spiro A, Speizer FE. However, normal lung volumes may differ significantly between different ethnic populations and subpopulations who may have higher pulmonary function tests (PFTs) volumes including forced vital capacity (FVC) and forced expiratory volume in one second (FEV 1) than average population independently from predicted body weight. Small airway dysfunction by impulse oscillometry in asthmatic patients with normal forced expiratory volume in the 1st second values. A FEV1/FVC < 70 % where FEV1 is reduced more than FVC signifies an obstructive defect (Figure 2). What are the Total Lung Capacity (TLC), Forced Expiratory Volume over 1 second (FEV1), and Ventilation/Perfusion Ratio (V/Q) for Pulmonary Embolism (increased, decreased, normal)?. Patients with restrictive lung disease will have a normal value of 80% (curve Z). FEV1 is the standard unit of measurement used by doctors to analyze the respiratory health. ERV: Valley of tidal volume to valley of expiration. FEV1 – The Forced Expiratory Volume in 1 Second parameter measures the volume of air that was exhaled into the mouthpiece in the first second after a full inhalation. Forced expiratory volume (FEV1) Forced expiratory volume is the amount of air forcefully exhaled in one second following a deep inhalation (FEV1). We hypothesize that a shor-tened baseline pre-MIC FET 100% (<4sec) may sig- a maximum forceful expiration. Questions to think about: ... but the shape is generally the same as in normal volume. Numerous CT studies have shown that the emphysema phenotype is associated with a rapid decline in forced expiratory volume in 1 second (FEV … Other indices, such as forced expiratory flow between 25% and 75% of FVC (FEF normal forced expiratory volume in 1 second (FEV 1) (L) ≥80% predicted, forced vital capacity (FVC) (L)80%≥ predicted, and FEV 1/FVC≥70% or greater than age corrected lower limit of normal (LLN). 75 – 85% of the vital capacity. Although counterintuitive, we have previously observed that in a large number of com-pletePFTsdonepriortoMICs,manypatientswith positive MICs had a shortened forced expiratory time (FET 100%) (3). 10. FEV1 >80% of predicted; Mild Obstructive Lung Disease. Normal ~ 1.2L 15 The second key spirometry measurement is forced expiratory volume (FEV1). 9 Forced Expiratory Volume at the 0.5 seconds (FEV 0.5). It is the measure of maximum amount of air that an person can exhale forcefully in a second. Forced expiratory volume in 1 second (FEV1) FEV1 is the volume of air that can forcibly be blown out in first 1 second, after full inspiration. 1.5L]. The normal value for this ratio is above 0.75. 1994; 49 : 775-780 View in Article Forced expiratory volume (FEV) measures how much air a person can exhale during a forced breath. We have followed the nomenclature for the The tests look at: How much air your lungs can hold. Normal: 1200 ml. Forced vital capacity (FVC) is the total amount of air exhaled during the FEV test. The mean forced expiratory volume in 1 second for both the overweight/obese and normal weight groups was approximately 83% of predicted flow, and the mean peak expiratory flow in midlung volume for both was approximately 77% of predicted volume, independent of body mass index. nethayroldenga nethayroldenga 03/20/2017 Physics High School answered • expert verified Under normal conditions, the forced expiratory volume is normally _____. Normal finding [1] [2] [3] Peak expiratory flow : The maximum airflow rate attained during forced expiration (in L/s) ≥ 80% of the predicted average value based on race, height, gender, and age ; Vital capacity. Expiratory Reserve Volume (ERV): The volume of air that is expelled from the lung during a maximal forced expiration that starts at the end of normal tidal expiration (1.5L). If inspiratory airflow is assessed, forced inspiratory vital capacity (FIVC) is also measured (Table 2). There is a leak in the system. Fev1 refers to Forced Expiratory Volume. Forced Expiratory Vital Capacity and Forced Expiratory Volume. Citation: Nwagha U, Iyare E, Anyaehie U, Onyedum C, Okereke C, Ajuzieogu O, et al.Forced expiratory volume in 6 s (FEV 6) and FEV 1 /FEV 6 values as a viable alternative for forced vital capacity (FVC) and FEV 1 /FVC values during pregnancy in South East Nigeria: A … Measures of forced maximal flow during expiration and inspiration can be also made either absolutely, eg. Small studies suggest 4 main flow-volume loop morphologies: low maximum forced expiratory flow, biphasic expiratory curve, flow oscillations, and notching. It is the measure of maximum amount of air that an person can exhale forcefully in a second. Access provided by MSN Academic Search . This value is often expressed as a % of FVC (i.e., FEV1/FVC %). FEV1, or forced expiratory volume, is a measurement taken from a pulmonary function test. Use of forced vital capacity and forced expiratory volume in 1 second quality criteria for determining a valid … peak expiratory flow rate (PEFR), or as a function of volume thus generating a flow-volume curve, the shape of which also contains information of diagnostic value. FEV values greater than 80% of the predicted average value are considered to be normal. Forced Expiratory Volume The ratio of FEV1/FVC should be 75% or higher. FEV is short for forced expiratory volume. Forced expiratory volume in 1 second (FEV1) FEV1 is the volume of air that can forcibly be blown out in first 1 second, after full inspiration. Lin C-K, Lin C-C. Work of breathing and respiratory drive in obesity. Forced expiratory flows at functional residual capacity (VmaxFRC) by the rapid compression technique and functional residual capacity (FRC) by the helium dilution technique were assessed in 112 normal infants with a mean age of 10.7 months (range, • Normal subjects can exhale 75- 80% of their FVC in the first second, hence the FEV1/FVC ratio is an important determinant in assessing lung disease. You need to answer for all 3 components TLC/FEV1/and V/Q: A recent estimate for the normal range of forced expiratory tracheal collapse differs substantially from that in an earlier study performed with comparable measurement methods. 57. Pulmonary function data are measured with flow volume spirometer from volunteers (N=175) using a standard data acquisition protocol. PEF is the maximum speed of the air when exhaling. A Peak Flow Meter, on the other hand, only measures the rate at which air is forced out of the lungs. We studied common PFT and flow-volume loop patterns among the largest prospective series of patients to date, undergoing clinical evaluation for symptomatic moderate to severe TBM. The FEV1/FVC ratio, also called Tiffeneau-Pinelli index, is a calculated ratio used in the diagnosis of obstructive and restrictive lung disease. It can also measure the rate at which a certain volume of air is expelled from the lungs. FEV1/ FVC ratio This number represents the percent of the lung size (FVC) that can be exhaled in one second (FEV1). IRV: Peak of tidal volume to peak of inspiration. Article: Ratio of Forced Expiratory Volume in 1 second /Slow Vital Capacity (FEV 1/SVC)<0.7 is associated with clinical, functional, and radiologic features of obstructive lung disease in smokers with preserved lung function Authors: Spyridon Fortis, Alejandro Comellas, Surya P Bhatt, Eric A Hoffman, MeiLan K Han, Nirav R Bhakta, Robert Paine 3rd, Bonnie Ronish, Richard… Article: Ratio of Forced Expiratory Volume in 1 second /Slow Vital Capacity (FEV 1/SVC)<0.7 is associated with clinical, functional, and radiologic features of obstructive lung disease in smokers with preserved lung function Authors: Spyridon Fortis, Alejandro Comellas, Surya P Bhatt, Eric A Hoffman, MeiLan K Han, Nirav R Bhakta, Robert Paine 3rd, Bonnie Ronish, Richard… Tidal breathing is normal, resting breathing; the tidal volume is the volume of air that is inhaled or exhaled in only a single such breath.. FEV 1, forced expiratory volume in 1 second; FEF 25-75, average forced expiratory flow rate over the middle 50% of the FVC. Most respiratory function test results show a 'normal' decline as part of the normal aging process. Expiratory and inspiratory forced vital capacity and one-second forced volume in asymptomatic never-smokers in Norway. A Spirometer measures the total volume of air that can be exhaled or inhaled. The normal values for FEV1 vary from person to person. My email alerts However, in COPD the pathologic site of small airway obstruction and emphysema begins in the small peripheral airways ≤ 2mm id Main Outcome Measures: For LC-EF, forced vital capacity, maximum forced expiratory flow, forced expiratory volume in 1 second, and peak expiratory flow; and lumbar lordosis. c. Smoking causes emphysema, a type of chronic obstructive pulmonary disorder. FEF 25(50,75), forced expiratory flow after 25% (50%, 75%) of the FVC has been exhaled. In addition, because the forced expiration is induced from a higher lung volume, full forced expiratory flow-volume curves appear to be possible (Fig. More specifically, and as its name suggests, it is the amount that is exhaled in the first second of purposefully trying to breathe out as much air as possible. The flow-volume loop is a plot of inspiratory and expiratory flow (on the Y-axis) against volume (on the X-axis) during the performance of maximally forced inspiratory and expiratory maneuvers . TLC: The volume of the lungs at maximal inflation, which is the sum of VC and RV. Normal spirometry values vary, but they generally are considered normal when the forced expiratory volume, or FEV1, is less than 80 percent of the predicted value. Forced Inspiratory Flow at 75% of FVC (FIF 75%) represents the flow rate at the 75% point relative to the total volume to be inhaled. See the first two tests above. Common abbreviation is ERV. Get the answers you need, now! Measures of forced maximal flow during expiration and inspiration can be also made either absolutely, eg. Expiratory reserve volume – which is the volume of air that can be extracted forcefully during exhalation, after the expiration of the normal volume. Fingerprint Dive into the research topics of 'Liver enzyme elevation and normal pulmonary function in an adult with a declining forced expiratory volume in 1 second'. This is a measure of how much air can be exhaled in one second following a deep inhalation. B. 9 Forced Expiratory Volume at the 0.5 seconds (FEV 0.5). Forced expiratory volume at 1, 2, or 3 second will decrease while forced vital capacity may be normal. Together they form a unique fingerprint. Forced vital capacity and forced expiratory volume in six seconds as predictors of reduced total lung capacity. Forced expiratory volume (FEV1) Forced expiratory volume is the amount of air forcefully exhaled in one second following a deep inhalation (FEV1). Forced expiratory volume in 1 sec was normal. Another exceedingly useful clinical pulmonary test, and one that is also simple, is to make a record on a spirometer of the forced expiratory vital capacity(FVC).Such a record is shown in Figure 42–3A for aperson with normal lungs and in Figure 42–3B for a person with partial airway obstruction. Residual volume (RV), about 1,200 mL, is the volume of air still remaining in the lungs after the expiratory reserve volume is exhaled. Residual Volume (RV): The volume of air left in the lungs after a maximal forced expiration (1.5L). FVC – Forced vital capacity. forced expiratory volumes. Clues from inspiration: b. Normal or lower . ... a functional residual capacity (FRC) of 3300 ml, and an expiratory reserve volume (ERV) of 1500 ml. Thorax. Normal values for F.E.V.1.0 were pre-dicted from the formula of Kory, Callahan, Boren, and Syner (1961) for men, and of Kory, Smith, and Callahan (to bepublished) for women. FVC is reduced in restrictive disease and also in obstructive disease if air-trapping occurs. Forced expiratory volume: The volume of air that can be forced out taking a deep breath, an important measure of pulmonary function. exercise changes in blood CO2 levels and changes in the pH of the blood Nervous system centers set the normal resting rate and depth of respiration. The effectiveness of lower limit of normal criteria and cutoff rate of forced expiratory volume in 1 s/forced expiratory volume in 6 s using in the diagnosis of airway obstruction in chronic obstructive pulmonary disease patients diagnosed with fixed ratio. FVC (forced vital capacity): the determination of the vital capacity from a maximally forced expiratory effort. The amount of air that can be forcefully expired after a normal tidal volume expiration is called (c) expiratory reserve volume. Eur Respir J. The main change seen on PFT is an approximately 20% drop in FRC (that portion of a breath that can still be exhaled after normal resting exhalation), due to a decrease in both expiratory reserve volume (ERV) and residual volume (RV). 2008;31(2):391-5. Forced expiratory volume and forced vital capacity are lung function tests that are measured during spirometry. FEV1 (forced expiratory volume in 1 second) should be above 80% of predicted values to be considered normal. Forced Expiratory Volume Over Time. 1 now define obstructive ventilatory defect not only on the basis of a low forced expiratory volume in one second (FEV1)/vital capacity (VC) ratio but also as a particular pattern with a normal FEV1/VC ratio. The normal FVC range for an adult is between 3 liters and 5 liters. Obstructive ventilatory defect with normal forced expiratory volume in one second/vital capacity ratio [1] June 2006 European Respiratory Journal 27(5):1069-70; author reply 1070 The forced expiratory vital capacity test also measures the volume exhaled in 1 second, called the 1-second forced expiratory volume (FEV1). Distribution of forced expiratory volume in one second and forced vital capacity in healthy, white, adult never-smokers in six U.S. cities. Forced vital capacity (FVC) Forced vital capacity (FVC) is the volume of air that can forcibly be blown out after full inspiration, measured in liters. peak expiratory flow rate (PEFR), or as a function of volume thus generating a flow-volume curve, the shape of which also contains information of diagnostic value. Total Lung Capacity (TLC) is the total amount of air in the lungs after inhaling a deep breath. Normal value – 75-80% (1960), members of this unit have measured the forced expiratory volume (F.E.V.Q 75 and F.E.V.J and the forced … Normal ~ 1.2L Residual Volume (RV) - the volume left in the lungs after maximal expiration. The manoeuvre is performed together with the assessment of the FEV 1 and of maximum expiratory flow-volume curves. Values lower than 0.70 are suggestive of airflow limitation with an obstructive pattern whilst in restrictive lung diseases, the FEV1/FVC ratio is normal … (FEV1.0) • FEV1.0/FVC ratio • FEF25-75% - forced expiratory flow between the 25th and 75th percent of an exhaled breath • Peak flow rate (PEF, PEFR) – highest flow rate achieved during expiration
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