Interpretative strategies for lung function tests
Riccardo Pellegrino,Giovanni Viegi,Vito Brusasco,Robert O. Crapo,Felip Burgos,Richard Casaburi,Allan L. Coates,C.P.M. van der Grinten,P. Gustafsson,John L. Hankinson,R. Jensen,D.C. Johnson,Neil R. MacIntyre,Roy T. McKay,Martin R. Miller,Daniel Navajas,O. F. Pedersen,J. Wanger +17 more
TLDR
This section is written to provide guidance in interpreting pulmonary function tests (PFTs) to medical directors of hospital-based laboratories that perform PFTs, and physicians who are responsible for interpreting the results of PFTS most commonly ordered for clinical purposes.Abstract:
SERIES “ATS/ERS TASK FORCE: STANDARDISATION OF LUNG FUNCTION TESTING”
Edited by V. Brusasco, R. Crapo and G. Viegi
Number 5 in this Series
This section is written to provide guidance in interpreting pulmonary function tests (PFTs) to medical directors of hospital-based laboratories that perform PFTs, and physicians who are responsible for interpreting the results of PFTs most commonly ordered for clinical purposes. Specifically, this section addresses the interpretation of spirometry, bronchodilator response, carbon monoxide diffusing capacity ( D L,CO) and lung volumes.
The sources of variation in lung function testing and technical aspects of spirometry, lung volume measurements and D L,CO measurement have been considered in other documents published in this series of Task Force reports 1–4 and in the American Thoracic Society (ATS) interpretative strategies document 5.
An interpretation begins with a review and comment on test quality. Tests that are less than optimal may still contain useful information, but interpreters should identify the problems and the direction and magnitude of the potential errors. Omitting the quality review and relying only on numerical results for clinical decision making is a common mistake, which is more easily made by those who are dependent upon computer interpretations.
Once quality has been assured, the next steps involve a series of comparisons 6 that include comparisons of test results with reference values based on healthy subjects 5, comparisons with known disease or abnormal physiological patterns ( i.e. obstruction and restriction), and comparisons with self, a rather formal term for evaluating change in an individual patient. A final step in the lung function report is to answer the clinical question that prompted the test.
Poor choices made during these preparatory steps increase the risk of misclassification, i.e. a falsely negative or falsely positive interpretation for a lung function abnormality or a change …read more
Citations
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Assessment of acute bronchodilator effects from specific airway resistance changes in stable COPD patients
Pierachille Santus,Dejan Radovanovic,Sonia Henchi,Fabiano Di Marco,Stefano Centanni,Edgardo D'Angelo,Matteo Pecchiari +6 more
TL;DR: In assessing the acute functional effect of bronchodilators, ΔsRAW-based criterion is preferable to FEV1-FVC-based criteria, being more closely related to bronchidilator-induced improvements of lung mechanics and dyspnea at rest.
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Neonatal Caffeine Treatment and Respiratory Function at 11 Years in Children under 1,251 g at Birth
TL;DR: Caffeine treatment in the newborn period improves expiratory flow rates in midchildhood, which seems to be achieved by improving respiratory health in the neonatal period.
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Lung Function of Adults Born at Very Low Birth Weight.
Jun Yang,Rachel A. Kingsford,John Horwood,Michael J. Epton,Maureen P. Swanney,Josh D. Stanton,Brian A Darlow +6 more
TL;DR: Pulmonary effects due to VLBW persist into adulthood, and BPD is a further insult on small airway function, according to a New Zealand national cohort of adult survivors born V LBW.
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Exhaled Nitric Oxide in Children with Allergic Rhinitis and/or Asthma: A Relationship with Bronchial Hyperreactivity
TL;DR: This study highlights the relevance of FeNO as possible marker for BHR in allergic children and underlines the close link between upper and lower airways.
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Low forced expiratory volume is associated with earlier death in sickle cell anemia.
Adetola A. Kassim,Amanda B. Payne,Mark Rodeghier,Eric A. Macklin,Robert C. Strunk,Michael R. DeBaun +5 more
TL;DR: Understanding the pathophysiology of a low FEV1 percent predicted in individuals with SCA is warranted, enabling early intervention for those at risk of death.
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Standardisation of spirometry
Martin R. Miller,John L. Hankinson,Vito Brusasco,Felip Burgos,Richard Casaburi,Allan L. Coates,Robert O. Crapo,Paul L. Enright,C.P.M. van der Grinten,P. Gustafsson,R. Jensen,D.C. Johnson,Neil R. MacIntyre,Roy T. McKay,Daniel Navajas,O. F. Pedersen,Riccardo Pellegrino,Giovanni Viegi,J. Wanger +18 more
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Standardisation of spirometry
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