Spirometry

Abstract

Pulmonary function testing is useful for the diagnosis and management of a variety of pulmonary conditions, and the most commonly obtained component is spirometry. Spirometry is most useful in the evaluation of obstructive airway disorders but can be a helpful tool in the management of patients with chest restriction or mixed disease. The utility of spirometry depends on reproducibility, standardization, and quality of testing. Accurate interpretation of test results depends on the availability of reference equations applicable to the subject undergoing testing. This paper reviews basic concepts, testing procedures, and interpretation of a single set of spirometry results as well as results obtained over time and gives an overview of previously published reference equations.

Spirometry Reference Equations for Central European Populations from School Age to Old Age

“…Most published reference equations use statistical methods that cannot adequately model the complexity of age-dependent lung function [2] and very few span across all ages [3] introducing discontinuities at the transition points with potential clinical implications for individuals with chronic lung diseases.”…”

“…However, most spirometry reference equations are derived from healthy non-smoking individuals [3] who are generally a small subsample and have higher reference values than the general population [24]. Some authors have therefore included smokers in their reference population when the smoking prevalence was high [25].…”

“…In Europe, the most commonly used reference equations are outdated [2] and the continued publication of new reference equations [3] reflects the widespread recognition of the limitations of the existing ones. Most reference equations are indeed inappropriate for central European populations as they have either been derived from a small or non-European population [3] or used statistical methods that cannot adequately model the complexity of age-dependent lung function [2]”. Additionally, published reference values are mostly derived from healthy never-smoking populations of restricted age ranges [3] and should not be extrapolated beyond the published range [1], [4], [5].…”

“…Most reference equations are indeed inappropriate for central European populations as they have either been derived from a small or non-European population [3] or used statistical methods that cannot adequately model the complexity of age-dependent lung function [2]”. Additionally, published reference values are mostly derived from healthy never-smoking populations of restricted age ranges [3] and should not be extrapolated beyond the published range [1], [4], [5]. Practically, however, clinicians often track disease progression over long periods or assess effectiveness of therapy over time in patients who are not “healthy never-smokers”.…”

Novel Challenges for the Allergist

“…First, new molecular tools, as in the case of proteomics for immune-mediated diseases [26], apply to food allergy [27,28] and are expected to improve food allergy diagnosis, therapy, and allergenic risk assessment, but the high current costs do not allow a routine use of high-specificity methods towards personalized medicine [29]. Second, the availability of sensitive laboratory methods has significantly modified our approach to asthma [30][31][32], as in the case of exhaled carbon monoxide in the meta-analysis by Shaoquin et al [33]. Third, significant developments have been obtained from the study of epigenetics in determining the susceptibility to immunological disorders [34][35][36].…”