Pulmonary Function Tests: Easy Interpretation in Three Steps

被引:4
作者
Ora, Josuel [1 ,2 ,3 ]
Giorgino, Federica Maria [1 ]
Bettin, Federica Roberta [2 ]
Gabriele, Mariachiara [1 ]
Rogliani, Paola [1 ,2 ]
机构
[1] Univ Hosp Tor Vergata, Div Resp Med, I-00133 Rome, Italy
[2] Univ Roma Tor Vergata, Dept Expt Med, Unit Resp Med, I-00133 Rome, Italy
[3] Fdn Policlin Tor Vergata, Dept Emergency Med, Viale Oxford 81, I-00133 Rome, Italy
关键词
spirometry; lung volumes; interpretation; PRISm; dysanaptic patterns; ABANDON FEV1/FVC LESS-THAN-0.70; LUNG-DISEASE; FLOW; OBSTRUCTION; SPIROMETRY; MORTALITY; VOLUME; COPD; AIR; STANDARDIZATION;
D O I
10.3390/jcm13133655
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Pulmonary function tests (PFTs) are pivotal in diagnosing and managing a broad spectrum of respiratory disorders. These tests provide critical insights into lung health, guiding diagnoses, assessing disease severity, and shaping patient management strategies. This review addresses the complexities and nuances inherent in interpreting PFT data, particularly in light of recent updates from the European Respiratory Society (ERS) and American Thoracic Society (ATS). These updates have refined interpretive strategies, moving away from definitive diagnostic uses of spirometry to a more probabilistic approach that better accounts for individual variability through the use of Z-scores and lower limits of normal (LLNs). Significantly, this narrative review delves into the philosophical shift in spirometry interpretation, highlighting the transition from direct clinical diagnostics to a more nuanced evaluation geared towards determining the likelihood of disease. It critiques the reliance on fixed ratios and emphasizes the need for reference values that consider demographic variables such as age, sex, height, and ethnicity, in line with the latest Global Lung Function Initiative (GLI) equations. Despite these advances, challenges remain in ensuring uniformity across different predictive models and reference equations, which can affect the accuracy and consistency of interpretations. This paper proposes a streamlined three-step framework for interpreting PFTs, aiming to unify and simplify the process to enhance clarity and reliability across various medical specialties. This approach not only aids in accurate patient assessments but also mitigates the potential for misdiagnosis and ensures more effective patient management. By synthesizing contemporary guidelines and integrating robust physiological principles, this review fosters a standardized yet flexible approach to PFT interpretation that is both scientifically sound and practically feasible.
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页数:18
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共 72 条
[11]   Forced vital capacity, slow vital capacity, or inspiratory vital capacity: Which is the best measure of vital capacity? [J].
Chhabra, SK .
JOURNAL OF ASTHMA, 1998, 35 (04) :361-365
[12]   Characterising airway obstructive, dysanaptic and PRISm phenotypes of prematurity-associated lung disease [J].
Cousins, Michael ;
Hart, Kylie ;
Kotecha, Sarah J. ;
Henderson, A. John ;
Watkins, W. John ;
Bush, Andrew ;
Kotecha, Sailesh .
THORAX, 2023, :895-903
[13]   The Prevalence of Expiratory Flow Limitation in Youth Elite Male Cyclists [J].
Cox, Katherine R. ;
Smith, Joshua R. ;
Luden, Nicholas D. ;
Saunders, Michael J. ;
Kurti, Stephanie P. .
MEDICINE AND SCIENCE IN SPORTS AND EXERCISE, 2020, 52 (09) :1933-1939
[14]   Body plethysmography - Its principles and clinical use [J].
Criee, C. P. ;
Sorichter, S. ;
Smith, H. J. ;
Kardos, P. ;
Merget, R. ;
Heise, D. ;
Berdel, D. ;
Koehler, D. ;
Magnussen, H. ;
Marek, W. ;
Mitfessel, H. ;
Rasche, K. ;
Rolke, M. ;
Worth, H. ;
Joerres, R. A. .
RESPIRATORY MEDICINE, 2011, 105 (07) :959-971
[15]   Exploring Current Concepts and Challenges in the Identification and Management of Early-Stage COPD [J].
Dona, Esperanza ;
Reinoso-Arija, Rocio ;
Carrasco-Hernandez, Laura ;
Domenech, Adolfo ;
Dorado, Antonio ;
Lopez-Campos, Jose Luis .
JOURNAL OF CLINICAL MEDICINE, 2023, 12 (16)
[16]   RAPID PLETHYSMOGRAPHIC METHOD FOR MEASURING THORACIC GAS VOLUME - COMPARISON WITH A NITROGEN WASHOUT METHOD FOR MEASURING FUNCTIONAL RESIDUAL CAPACITY IN NORMAL SUBJECTS [J].
DUBOIS, AB ;
BOTELHO, SY ;
BEDELL, GN ;
MARSHALL, R ;
COMROE, JH .
JOURNAL OF CLINICAL INVESTIGATION, 1956, 35 (03) :322-326
[17]   Mortality and cardiovascular and respiratory morbidity in individuals with impaired FEV1 (PURE): an international, community-based cohort study [J].
Duong, MyLinh ;
Islam, Shofiqul ;
Rangarajan, Sumathy ;
Leong, Darryl ;
Kurmi, Om ;
Teo, Koon ;
Killian, Kieran ;
Dagenais, Gilles ;
Lear, Scott ;
Wielgosz, Andreas ;
Nair, Sanjeev ;
Mohan, Viswanathan ;
Mony, Prem ;
Gupta, Rajeev ;
Kumar, Rajesh ;
Rahman, Omar ;
Yusoff, Khalid ;
du Plessis, Johannes Lodewykus ;
Igumbor, Ehimario U. ;
Chifamba, Jephat ;
Li, Wei ;
Lu, Yin ;
Zhi, Fumin ;
Yan, Ruohua ;
Iqbal, Romaina ;
Ismail, Noorhassim ;
Zatonska, Katarzyna ;
Karsidag, Kubilay ;
Rosengren, Annika ;
Bahonar, Ahmad ;
Yusufali, Afazalhussein ;
Lamelas, Pablo M. ;
Avezum, Alvaro ;
Lopez-Jaramillo, Patricio ;
Lanas, Fernando ;
O'Byrne, Paul M. ;
Yusuf, Salim .
LANCET GLOBAL HEALTH, 2019, 7 (05) :E613-E623
[18]   Counterpoint: Should We Abandon FEV1/FVC <0.70 To Detect Airway Obstruction? Yes [J].
Enright, Paul ;
Brusasco, Vito .
CHEST, 2010, 138 (05) :1040-1042
[19]   Clinical and functional correlations of the difference between slow vital capacity and FVC [J].
Fernandez, Jonathan Jerias ;
Cruz de Oliveira Castellano, Maria Vera ;
Filardo Vianna, Flavia de Almeida ;
Nacif, Sergio Roberto ;
Rodrigues Junior, Roberto ;
Sousa Rodrigues, Silvia Carla .
JORNAL BRASILEIRO DE PNEUMOLOGIA, 2020, 46 (01)
[20]  
Global Initiative for Asthma, 2023, Diagnosis and management of difficult-to-treat & severe asthma