Reprinted with permission from Crapo RO. Pulmonary-function testing. N Engl J Med ; Once the ventilatory pattern is identified, the severity of the disease must be determined. The final step in interpreting spirometry is to determine if additional testing is needed to further define the abnormality detected by spirometry. Measurement of static lung volumes, including FRC, is required to make a definitive diagnosis of restrictive lung disease.
Basic spirometry can be performed in the family physician's office with relative ease and inexpensive equipment. In most cases, office spirometry provides an adequate assessment of pulmonary function. In addition, spirometry may be used to address major issues in clinical management and health screening. Already a member or subscriber? Log in. Interested in AAFP membership?
Learn more. Perillo earned her medical degree from State University of New York Upstate Medical University, Syracuse, and completed an internal medicine residency, and pulmonary and critical care fellowship at the University of Rochester School of Medicine and Dentistry. Address correspondence to Timothy J. Barreiro, D. Reprints are not available from the authors. The authors indicate that they do not have any conflicts of interest.
Sources of funding: none reported. Evidence-based health policy—lessons from the Global Burden of Disease Study.
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Statement on technical standards for peak flow meters. Peak flow records in surveys: reproducibility of observers reports. Attach the spirometer cable to the computer with the two screws on the connector, otherwise it will fall off easily. Attach the printer cable to the rear of the PC. Attach all power plugs to the switched outlet strip. The following files are distributed on 3. The total size of these 8 files for one participant is about 8 Kbytes.
DOC is a redundant database file which contains the numeric results from the best single FVC maneuver for all participants ever tested on the workstation. DAT is a large empty database file which enables other users to create and store multiple lines of free text comments or interpretations in addition to those stored in the individual DATAxxxx.
TXT files for each participant. DAT file, but it cannot be deleted. LOG is also located in the PD93 subdirectory. It stores the results of CAL checks. It is formatted so that it may be printed using a simple DOS copy command on 8. A comments line follows each cal check record.
The Adjustments columns are used only when a recalibration adjustment was performed. Several result files are created temporarily during test sessions, but are overwritten whenever a new participant is selected by the INF program:. The PTA. DOC is copied to a file called yyyyyyy. DAT to store the results. However, for reference purposes, the correct configuration setting for the CHS are as follows:.
The Printer Workstation will compare the observed values to those predicted by the CHS baseline data from the healthy participants 27 , and then interpret them based on the American Thoracic Society recommendations for disability testing 28 :.
Only pins 2,3,5,8,9 are connected. You may then move the spirometer bell up and down and watch the Volume and Flow change. Channel 1 is spirometer Volume. It should be near zero 0—50 when the pen is on the baseline, and increase to close to when the bell is raised to 8. If not, the potentiometer or its connections may be bad. It should be about with no spirometer motion. It should flicker to higher or lower values when the spirometer bell is moved. It should remain constant at about counts.
Channel 4 is the spirometer temperature. It should be between and at room temperature higher at higher temperatures. Study phs Feasibility of QC Procedures. Implementation of QC Procedures. PEF Training. PF is short for Pulmonary Function lung tests. Prediction equations for healthy elderly women and men. The first column of selections, under the heading PRE:Tests lists the most frequently used programs in the order in which they are usually selected: INF - Enter patient information Used to enter the name, ID number, age, height, etc for a new participant.
TXT - Enter Comments You may go back and edit your comments about what happened during testing at any time. Date: Verify that the computer knows the correct date. Sex: Press M for male or F for female.
Wash your Hands Participants will appreciate your consideration if you make a point of washing your hands before testing them. The FVC Incentive screen will then be displayed. Glance at it. Perhaps draw his attention to it and the horizontal bar.
You will hear a beep when the EOT criterion is met, but keep coaching him to keep blowing out the air until only the green portion of the EOT plateau bar is showing or 15 seconds has elapsed. Review the Results After the participant has performed three apparently good FVC maneuvers, review the results. Maneuver Quality Review Window F10 The best three maneuvers are again indicated at the top of the columns.
Maximum Number of Maneuvers. Sample SVC tracing:. Instruct the participant to seal their lips around the mouthpiece and breathe normally from the spirometer. Press the spacebar to begin the test when they have begun breathing from the spirometer.
Note the blue tracing of their breathing pattern starting on the left side of the screen. Allow him to breathe normally for a couple of breaths. Then coach him to take as deep a breath as possible. Look at him to see if he is doing so. A lung infection or exposure to cigarette smoke can affect your results too, so it is important that you discuss these issues with your healthcare provider before having your test.
If needed, your FVC may be rescheduled. The FVC test itself should only take a few minutes, but be sure to ask your medical team how long you should expect to spend at the testing site. There are other aspects to pulmonary testing, such as functional residual capacity FRC , and you may need a variety of tests if your pulmonary condition has been difficult to diagnose or if you are not improving as expected.
Your whole battery of tests could take an hour or longer. Be sure to wear loose clothing so that you will not feel restricted when you are breathing.
It is important that you can take your maximum inspiration and expiration during the test. You will not have to make any adjustments to your food and drink prior to or after having an FVC test. If you have health insurance, your carrier may cover all or part of that cost. Be sure to check with your insurer to ask whether you will have to pay a co-pay or the whole cost of the test.
Keep in mind that if you are having other pulmonary tests, your total cost will be higher. When you go to have your FVC test, be sure to bring a list of all of your medications, a form of identification, your health insurance information, and a form of payment. Bring your inhalers with you, even if you have been instructed not to use them prior to your test; you may be asked to use your inhaler during your test.
When you arrive for your test, you will be asked to sign in and provide your paperwork. Spirometry is non-invasive and only takes a few minutes. Other pulmonary function tests will likely be performed at this same appointment. FVC spirometry is performed as follows:. The procedure is repeated at least three times to obtain a consistent and average value. You will most likely not need any recovery time after you have completed your FVC test. But if you feel dizzy or short of breath, be sure to tell your medical team.
You may be asked to sit for a few minutes as you recover. Additionally, if you are having persistent or serious symptoms, you might need to have your oxygen level checked. If it is low, you will be given supplemental oxygen.
Your FVC can also be compared with your own previous FVC values, if applicable, to determine whether your pulmonary condition is progressing or if your lung function is improving under treatment. Forced vital capacity will be reported in two ways:. Learn how we develop our content. To learn more about Healthwise, visit Healthwise. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Updated visitor guidelines.
Top of the page. Topic Overview Forced expiratory volume FEV measures how much air a person can exhale during a forced breath.
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