Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement

Abstract

Background: Spirometry is the most common pulmonary function test. It is widely used in the assessment of lung function to provide objective information used in the diagnosis of lung diseases and monitoring lung health. In 2005, the American Thoracic Society and the European Respiratory Society jointly adopted technical standards for conducting spirometry. Improvements in instrumentation and computational capabilities, together with new research studies and enhanced quality assurance approaches, have led to the need to update the 2005 technical standards for spirometry to take full advantage of current technical capabilities. Methods: This spirometry technical standards document was developed by an international joint task force, appointed by the American Thoracic Society and the European Respiratory Society, with expertise in conducting and analyzing pulmonary function tests, laboratory quality assurance, and developing international standards. A comprehensive review of published evidence was performed. A patient survey was developed to capture patients’ experiences. Results: Revisions to the 2005 technical standards for spirometry were made, including the addition of factors that were not previously considered. Evidence to support the revisions was cited when applicable. The experience and expertise of task force members were used to develop recommended best practices. Conclusions: Standards and consensus recommendations are presented for manufacturers, clinicians, operators, and researchers with the aims of increasing the accuracy, precision, and quality of spirometric measurements and improving the patient experience. A comprehensive guide to aid in the implementation of these standards was developed as an online supplement.

Combining Dynamic Hyperinflation with Dead Space Volume during Maximal Exercise in Patients with Chronic Obstructive Pulmonary Disease

“…of the distribution of a reference population [17] according to the 2019 ATS-ERS technical statement 316 [16]. In the present study, the use of GOLD criteria to define COPD could have introduced age, sex, 317…”

“…Bronchodilators were not administered within 3 h for short-acting beta agonists and 12 h for long-acting beta agonists before the tests [14,15]. FEV 1 , TLC, residual volume (RV), and diffusing capacity for carbon monoxide (D L CO) were measured using spirometry, body plethysmography, and the single-breath technique, respectively, in accordance with the currently recommended standards [16][17][18]. All of the spirometry data were obtained before and after inhaling a standard dose of fenoterol HCl.…”

“…Airflow obstruction should be defined as a FEV 1 /VC ratio below the fifth percentile (z-score −1.645) of the distribution of a reference population [17] according to the 2019 ATS-ERS technical statement [16].…”

Can Pediatricians Assess Exercise-Induced Bronchoconstriction From Post-exercise Videos?

“…Spirometry was performed using standard ATS/ERS protocol (11). The ECT was performed in a climate chamber with dry, cold (10.0-12.0 • C) air following widely used guidelines (5).…”

Calibration Myths in the 2019 American Thoracic Society/European Respiratory Society Spirometry Technical Standards

“…Updated American Thoracic Society/European Respiratory Society (ATS/ERS) technical standards for spirometry were recently published in the Journal. 1 Some recommendations regarding calibration verification are based on expert opinion, not science. While these recommendations would not cause any harm, they are unproven directives that clinicians will feel obligated to follow.…”