Spirometry and Bronchodilator Test

Abstract

Spirometry is a physiological test for assessing the functional aspect of the lungs using an objective indicator to measure the maximum amount of air that a patient can inhale and exhale. Acceptable spirometry testing needs to be conducted three times by an acceptable and reproducible method for determining forced vital capacity (FVC). Until the results of three tests meet the criteria of reproducibility, the test should be repeated up to eight times. Interpretation of spirometry should be clear, concise, and informative. Additionally, spirometry should guarantee optimal quality prior to the interpreting spirometry results. Our guideline adopts a fixed normal predictive value instead of the lower limit of normal as the reference value because fixed value is more convenient and also accepts FVC instead of vital capacity (VC) because measurement of VC using a spirometer is impossible. The bronchodilator test is a method for measuring the changes in lung capacity after inhaling a short-acting β-agonist that dilates the airway. When an obstructive ventilatory defect is observed, this test helps to diagnose and evaluate asthma and chronic obstructive pulmonary disease by measuring reversibility with the use of an inhaled bronchodilator. A positive response to a bronchodilator is generally defined as an increase of ≥12% and ≥200 mL as an absolute value compared with a baseline in either forced expiratory volume at 1 second or FVC.

Keywords: Bronchodilator Agents; Guideline; Lung; Spirometry.

Figure 1. Forced expiration implementation method.

Figure 2. Flow-volume curve of a normal person.

Figure 3. Flow chart of acceptability and reproducibility. FVC: forced vital capacity; FEV₁: forced expiratory volume at 1 second.

Figure 4. Flow chart of interpreting spirometry. ^*Possible to raise upward to 0.75–0.8 in young age group. FEV₁: forced expiratory volume at 1 second; FVC: forced vital capacity; ΔFVC: change of FVC; ΔFEV₁: change of FEV₁; TLC: total lung capacity.