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Peak expiratory flow is the greatest outward volumetric flow rate reached during a specified forced expiration. In an ideal continuous record,It has units of volume per time, commonly litres per second or litres per minute, whereas FEV1 and FVC are integrated volumes. The 2019 technical statement defines the peak from a maximal forced expiratory maneuver and specifies its reporting units.^[ref]

An original pair of triangular volumetric flow rate histories separates the quantities. Let numerical time be in seconds. One curve is $Q_1(t)=2(1-t)$ L/s over $0\le t\le 1$; the other is $Q_2(t)=4(1-2t)$ L/s over $0\le t\le 0.5$, followed by zero. Both expel 1 L in total and in the first second. Their peaks are nevertheless 2 and 4 L/s, or 120 and 240 L/min. Equal expired volume does not identify the highest volumetric flow rate.

The instrument history reflects the value of measuring that maximum directly. In 1959, Basil Martin Wright and C. B. McKerrow published a description of a portable instrument for maximum forced expiratory volumetric flow rate.^[ref] The Wood Library-Museum's original-object catalogue identifies its Wright peak flow meter, records the author as B. M. Wright (Basil Martin), and describes the instrument's portability.^[ref]

A peak flow meter and a full spirometer record different amounts of information. A retained peak does not reconstruct the preceding waveform or total volume. Conversely, numerical differentiation and finite sensor response can affect a peak inferred from a recorded volume trace. Adequate temporal response, effort and the starting lung volume belong to the measurement definition. The primary standard connects early volumetric flow rate and the peak with maneuver effort and requires complementary waveform displays.^[ref]

The triangular examples are mathematical constructions, not reference values or a diagnostic rule. Comparing peak measurements requires comparable units, maneuvers and instrument response rather than treating a maximum as a complete description of lung function.

A peak flow meter is an instrument that measures peak expiratory flow, the greatest outward volumetric flow rate reached during a specified forced expiration. A portable instrument can retain that maximum without recording the whole volume versus time history. A spirometer that records a suitable flow trace can also determine the maximum, but the two outputs contain different information.

Basil Martin Wright and C. B. McKerrow's 1959 primary paper described a portable instrument for maximum forced expiratory flow measurement.^[ref] The Wood Library-Museum preserves an Airmed example: its collection record places the device in the practical transition from bulky laboratory measurements to portable measurements.^[ref]

A peak alone cannot determine expelled volume. For two original triangular flow pulses, stipulate the same maximum $Q_p=8\mathrm{L}{\mathrm{s}}^{-1}$ but base durations 0.5 and 1.0 s. Their peaks both correspond to 480 L/min, while integrating their traces gives $Q_{p}D/2=2$ and 4 L. The second pulse expels twice as much air without a greater peak.

Finite instrument response introduces a separate issue. As an illustrative first-order low-pass filter model, suppose the indicated volumetric flow rate obeysFor a rectangular flow pulse of height $Q$ lasting $D$, the indicated peak is $Q(1-e^{-D/{\tau }_m})$. Durations $D={\tau }_m$ and $D=3{\tau }_m$ produce only about 63.2% and 95.0% of the input peak. This is a response model, not an assertion that the historical instrument has that exact mechanism or time constant.

A useful measurement therefore specifies the maneuver, units and instrument response as well as the displayed maximum. A retained peak does not establish forced vital capacity, forced expiratory volume in one second or lung compliance. Those require different information; spirometry standards distinguish equipment performance from maneuver quality.^[ref]

Spirometer calibration verification checks whether a spirometer measures a known input within specified limits. It differs from measurement calibration, which establishes the relation between input and indication, and from an adjustment that changes that relation. A satisfactory verification applies to the tested equipment, assembly and conditions; it does not validate a person's expiration maneuver.

The primary 2019 technical statement specifies daily verification with a 3-L syringe cycled over multiple flows. Its stated measured-volume accuracy requirement is ±3%, and a filter used for testing is also used during verification.^[ref] The known volume is useful precisely because it can be delivered at different speeds.

An original gain-and-offset model explains this design. If measured flow is $Q_m=gQ+b$, integrating one transfer of known volume $V_0$ over duration $T$ givesFor the same $V_0$ at two durations,A single transfer cannot distinguish gain from zero offset in this model; two different durations can.

Take stipulated 3.000 L transfers lasting 1 s and 6 s, reported as 3.020 and 3.120 L. The inferred offset is $0.100/5=0.020\mathrm{L}{\mathrm{s}}^{-1}$, while $g=1.000$. The slow transfer is 4% high, exceeding the cited 3% limit. If both transfers instead read 3.060 L, this model gives $g=1.020$ and $b=0$: a 2% gain error. These are constructed instrument responses, not a calibration record for an actual device.

Identifying flow-sensor gain and offset with timed transfers relies on the model assumptions. Nonlinear response, leaks or an inaccurately known syringe volume can produce other patterns. Reference-volume uncertainty belongs in the uncertainty budget, and repeated transfers share it rather than independently re-estimating it. A test at several flows is therefore more informative than repeating one convenient delivery speed.

Spirometry measures the volume of air moved into or out of the respiratory system as a function of time. A spirometer records displaced gas directly or derives volume by integrating volumetric flow rate. The resulting trace describes gas movement at the mouth; it does not independently determine alveolar pressure, pleural pressure or lung compliance.^[ref]

Two important outputs of a forced expiration following maximal inspiration are forced vital capacity, the total volume expelled in that maneuver, and forced expiratory volume in one second, the volume expelled during its first second. Their ratio compares early emptying with the eventual expelled volume.^[ref] Equal final volumes can accompany substantially different emptying rates.

An original mathematical example sets expelled volumewhere the numerical time $t$ and time constant $\tau$ are in seconds. Both $\tau =1$ and $\tau =2$ give an asymptotic expelled volume of 4 L. Their first-second volumes are instead $4(1-e^{-1})\approx 2.53$ L and $4(1-e^{-1/2})\approx 1.57$ L. The corresponding ratios to the limiting volume are approximately 0.632 and 0.393. These smooth toy curves explain the measurements; they are not measured traces or diagnostic reference limits.

Spirometry measures volume differences. The gas left after maximal expiration is residual lung volume, which has not crossed the instrument. Consequently a volume trace alone does not determine total lung capacity: different absolute starting volumes can produce the same expelled-volume trace. This is the absolute-volume ambiguity in spirometry.

Timing, effort, leaks and early termination can alter what a trace represents. Distinguish an instrumentally repeatable signal from a maneuver that answers the intended physiological question. The primary technical statement treats equipment quality assurance and maneuver acceptability separately.^[ref]