- •
Spirometry is useful in detecting and monitoring airway disease in patients with symptoms, risk factors or suspicion of airway disease.
- •
Spirometry should accurately measure forced expiratory volume in 1 second, forced vital capacity, or forced expiratory volume in 6 seconds, and it should be reported both as the absolute measurement and as a percentage of normative data.
- •
Spirometry should be used to diagnose disease as well as monitor response to therapy and progression of disease over time.
- •
The
Interpreting Spirometry: The Basics
Section snippets
Key points
Indications: who should be tested?
Spirometry is an invaluable tool as a screening test of general respiratory health in the same way that blood pressure monitoring provides important information about the general health of the cardiovascular system.7 Data from spirometry are also important to help convince patients with asthma to be more attentive to their disease, particularly those patients with mild intermittent asthma, who often have accommodated to their disease by modifying their lifestyles and avoiding situations that
Spirometry measurements
Spirometry records the forced airflow from fully inflated lungs. Spirometry includes measurement of the FVC, the amount of air exhaled from the lungs from a maximal inhalation to a maximal exhalation, and the FEV1. Both FEV1 (airflow) and FVC (air volume) can be compromised by airway narrowing, inflammatory and bronchospastic factors, and mucus plugging, which can obstruct or occlude some of the small (or even larger) airways. These values are typically reported in 2 ways: as a volume
Flow-Volume Loops
This approach to the data yields useful additional information beyond that obtained by analysis of FEV1 and FVC measurements.16, 17 Information generated during the office spirometry can be analyzed by plotting the data, creating a graph of the test known as the flow-volume loop (also called a spirogram). The flow-volume relationship or loop is created by plotting flow against volume during the FVC (forced expiratory) maneuver. The flow-volume loop is a plot of inspiratory and expiratory flow
Summary
Spirometry is useful to detect and monitor airway disease in patients with symptoms, risk factors, or suspicion of airway disease. Spirometric equipment is readily available and requires little maintenance and some calibration.
Acceptable tests require active patient participation and coaching. At least 3 quality maneuvers should be preformed. Clinician and technician must learn to recognize the patterns of an unacceptable test effort.
Spirometry should accurately measure FEV1, FVC (or FEV6), and
References (25)
- et al.
A randomized controlled trial on office spirometry in asthma and COPD in standard general practice: data from spirometry in asthma and COPD: a comparative evaluation Italian study
Chest
(2006) - et al.
Interpreting lung function data using 80% predicted and fixed thresholds misclassifies more than 20% of patients
Chest
(2011) - et al.
The role of FEV6 in the detection of airway obstruction
Respir Med
(2005) - et al.
FEV1/FEV6 and FEV6 as an alternative for FEV1/FVC and FVC in the spirometric detection of airway obstruction and restriction
Chest
(2005) - et al.
Office spirometry for lung health assessment in adults: a consensus statement from the National Lung Health Education Program
Chest
(2000) - et al.
Evaluation of bronchodilator response in patients with airway obstruction
Respir Med
(1999) - et al.
The utility of spirometry in the diagnosis of reversible airways obstruction
Chest
(1992) - et al.
Don’t diagnose mild COPD without confirming airway obstruction after an inhaled bronchodilator
COPD
(2007) - et al.
Screening for chronic obstructive pulmonary disease using spirometry: summary of the evidence for the U.S. Preventive Services Task Force
Ann Intern Med
(2008) National Asthma Education and Prevention Program: expert panel report III: guidelines for the diagnosis and management of asthma
(2007)
Spirometry to detect and manage COPD and asthma in the primary care setting
Eur Respir Mon
A mixed methods study to compare models of spirometry delivery in primary care for patients at risk of COPD
Thorax
Cited by (17)
An automated deep learning pipeline for detecting user errors in spirometry test
2024, Biomedical Signal Processing and ControlResponse to the Letter to the editor criticizing our recently published work
2024, Journal of Taibah University Medical SciencesEffect of intrathoracic oscillations on pulmonary functions in children with cerebral palsy
2023, Journal of Taibah University Medical SciencesPerformance and Interpretation of Office Spirometry
2021, Primary Care - Clinics in Office PracticePhiladelphia versus Miami-J cervical collar's impact on pulmonary function
2021, American Journal of Emergency MedicineCitation Excerpt :The present study indicated a significant decrease in FEV1, PEF, FEF25–75%, and FEV1/FVC, despite no significant changes in FVC before and after applying either type of collars. Given that FEV1 and FEV1/FVC ratio are the most important parameters in evaluating expiratory flow obstruction [12], both types are in charge of expiratory airflow limitation. Several studies [15] [16], compared Philadelphia and Miami-J collars regarding the level of cervical movement restriction and demonstrated that the Philadelphia collar was significantly more restrictive than Miami-J in all movement planes, which was in line with our findings.
Health effects of occupational exposure to printer emissions on workers in China: Cardiopulmonary function change
2021, NanoImpactCitation Excerpt :FVC is the maximal volume of air exhaled with a max forced effort, a marker of air trapping that predicting an obstructive disease state and survival in asymptomatic adults without chronic respiratory diagnoses or persistent respiratory symptoms(Hoesterey et al., 2019; Parker, 2014; Burney and Hooper, 2011). Reduced FVC indicated the trend of airflow limitation and restriction (Parker, 2014). FEV1 is not only the most important spirometric measurement for assessment of the severity of airflow obstruction(Parker, 2014), but also a marker of premature death from all causes, such as chronic obstructive pulmonary disease (COPD), lung cancer, coronary artery disease(Young et al., 2007).