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
[51]   Mechanisms, assessment and therapeutic implications of lung hyperinflation in COPD [J].
Rossi, Andrea ;
Aisanov, Zaurbek ;
Avdeev, Sergey ;
Di Maria, Giuseppe ;
Donner, Claudio F. ;
Luis Izquierdo, Jose ;
Roche, Nicolas ;
Similowski, Thomas ;
Watz, Henrik ;
Worth, Heinrich ;
Miravitlles, Marc .
RESPIRATORY MEDICINE, 2015, 109 (07) :785-802
[52]   FEV1 and FVC as robust risk factors for cardiovascular disease and mortality: Insights from a large population study [J].
Rydell, Andreas ;
Janson, Christer ;
Lisspers, Karin ;
Lin, Yi-Ting ;
Arnlov, Johan .
RESPIRATORY MEDICINE, 2024, 227
[53]   Is the Slow Vital Capacity Clinically Useful to Uncover Airflow Limitation in Subjects With Preserved FEV1/FVC Ratio? [J].
Saint-Pierre, Mathieu ;
Ladha, Jamil ;
Berton, Danilo C. ;
Reimao, Gabriel ;
Castelli, Giovana ;
Marillier, Mathieu ;
Bernard, Anne-Catherine ;
O'Donnell, Denis E. ;
Neder, J. Alberto .
CHEST, 2019, 156 (03) :497-506
[54]   The Relevance of Targeting Treatment to Small Airways in Asthma and COPD [J].
Santus, Pierachille ;
Radovanovic, Dejan ;
Pecchiari, Matteo ;
Ferrando, Matteo ;
Tursi, Francesco ;
Patella, Vincenzo ;
Braido, Fulvio .
RESPIRATORY CARE, 2020, 65 (09) :1392-1412
[55]   Preserved Ratio Impaired Spirometry in a Spirometry Database [J].
Schwartz, Andrei ;
Arnold, Nicholas ;
Skinner, Becky ;
Simmering, Jacob ;
Eberlein, Michael ;
Comellas, Alejandro P. ;
Fortis, Spyridon .
RESPIRATORY CARE, 2021, 66 (01) :58-65
[56]   Visualized changes in respiratory resistance and reactance along a time axis in smokers: A cross-sectional study [J].
Shinke, Haruko ;
Yamamoto, Masatsugu ;
Hazeki, Nobuko ;
Kotani, Yoshikazu ;
Kobayashi, Kazuyuki ;
Nishimura, Yoshihiro .
RESPIRATORY INVESTIGATION, 2013, 51 (03) :166-174
[57]   Practical surrogate marker of pulmonary dysanapsis by simple spirometry: an observational case-control study in primary care [J].
Shiota, Satomi ;
Ichikawa, Masako ;
Suzuki, Kazuhiro ;
Fukuchi, Yoshinosuke ;
Takahashi, Kazuhisa .
BMC FAMILY PRACTICE, 2015, 16
[58]   Spirometric variability in smokers: transitions in COPD diagnosis in a five-year longitudinal study [J].
Sood, Akshay ;
Petersen, Hans ;
Qualls, Clifford ;
Meek, Paula M. ;
Vazquez-Guillamet, Rodrigo ;
Celli, Bartolome R. ;
Tesfaigzi, Yohannes .
RESPIRATORY RESEARCH, 2016, 17
[59]   ERS/ATS technical standard on interpretive strategies for routine lung function tests [J].
Stanojevic, Sanja ;
Kaminsky, David A. ;
Miller, Martin R. ;
Thompson, Bruce ;
Aliverti, Andrea ;
Barjaktarevic, Igor ;
Cooper, Brendan G. ;
Culver, Bruce ;
Derom, Eric ;
Hall, Graham L. ;
Hallstrand, Teal S. ;
Leuppi, Joerg D. ;
MacIntyre, Neil ;
McCormack, Meredith ;
Rosenfeld, Margaret ;
Swenson, Erik R. .
EUROPEAN RESPIRATORY JOURNAL, 2022, 60 (01)
[60]   Official ERS technical standards: Global Lung Function Initiative reference values for the carbon monoxide transfer factor for Caucasians [J].
Stanojevic, Sanja ;
Graham, Brian L. ;
Cooper, Brendan G. ;
Thompson, Bruce R. ;
Carter, Kim W. ;
Francis, Richard W. ;
Hall, Graham L. .
EUROPEAN RESPIRATORY JOURNAL, 2017, 50 (03)