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Spirometry

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Pulmonary Function Tests in Clinical Practice

Abstract

Spirometry is the most essential part of any pulmonary function study and provides the most information. In spirometry, a machine called a spirometer is used to measure certain lung volumes, called dynamic lung volumes. The two most important dynamic lung volumes measured are the forced vital capacity (FVC) and the forced expiratory volume in the 1st second (FEV1). This section deals with the definitions of these and other terms.

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Notes

  1. 1.

    The flow can be measured directly by a pneumotachograph. The volume is obtained by integration of the flow signal. Alternatively, a volume sensing device (spirometer) measures volume and the flow is derived by differentiating the volume signal. Either method allows expression of the flow–volume curve.

  2. 2.

    As air in the lungs is at BTPS (body temperature pressure standard) but collected at ATPS (ambient temperature pressure standard), a correction factor has to be applied to obtain the BTPS volumes as these are the reported volumes.

  3. 3.

    Using a fixed value of the lower limit of normal (80%) may be accepted in children but may lead to some errors in adults.27

  4. 4.

    As can be seen in fi gure 1.14 the 95% confi dence limit may be used for normality as well. Values outside this range are then below the limit of normal (LLN). Many software programs for lung function testing can display the LLN and interpreting physicians may use this to determine normality. The predicted values used (reference equations) should be representative of the population being tested.

  5. 5.

    A spacer is an attachment to the MDI, which optimizes the delivery of salbutamol.

  6. 6.

    Increments of as high as 8% or 150 ml in FEV1 or FVC are likely to be within the variability of the measurement.36, 56

  7. 7.

    Another way is to think of the intrathoracic obstruction taking place during the ex-piration, while the extrathoracic during the in-spiration. So, intra- will take ex-, while extra- will take in-.

  8. 8.

    ** MIF50 & MEF50 are sometimes used to describe FIF50 & FEF50, respectively & they stand for the maximal inspiratory flow at 50% of FIVC and the maximal expiratory flow at 50% of FVC, respectively.

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Authors and Affiliations

  1. University of Toronto, 23 lvor Rd.,, M4N 2H3, North York, Ontario, Canada

    Ali Altalag

  2. The Lung Centre, Vancouver General Hospital, 7th Floor, 2775 Laurel Streen, V5Z 1M9, Vancouver, BC, Canada

    Jeremy Road

  3. Cpy Pauls Hospital, 1081 Burrard Street, V6Z 1Y6, Vancouver, BC, Canada

    Pearce Wilcox

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Altalag, A., Road, J., Wilcox, P. (2009). Spirometry. In: Pulmonary Function Tests in Clinical Practice. Springer, London. https://doi.org/10.1007/978-1-84882-231-3_1

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  • DOI: https://doi.org/10.1007/978-1-84882-231-3_1

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