Tuberc Respir Dis.  2017 Apr;80(2):105-112. 10.4046/trd.2017.80.2.105.

Spirometry and Bronchodilator Test

Affiliations
  • 1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
  • 2Department of Allergy, Pulmonary and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
  • 3Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 4Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.
  • 5Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 6Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 7Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea. hs1017@ewha.ac.kr
  • 8Division of Pulmonology and Critical Care, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.

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.

Keyword

Spirometry; Lung; Guideline; Bronchodilator Agents

MeSH Terms

Asthma
Bronchodilator Agents
Forced Expiratory Volume
Humans
Inhalation
Lung
Lung Volume Measurements
Methods
Pulmonary Disease, Chronic Obstructive
Reference Values
Spirometry*
Vital Capacity
Bronchodilator Agents

Figure

  • 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.


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