Spirometry Quality in Adults With Very Severe Lung Function Impairment

Torre-Bouscoulet, Luis; Velázquez-Uncal, Mónica; García-Torrentera, Rogelio; Gochicoa‐Rangel, Laura; Fernández-Plata, Rosario; Enright, Paul; Pérez‐Padilla, Rogelio

doi:10.4187/respcare.03457

Cited by 6 publications

(3 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A large occupational health study in an older population (mean age, 63 yr) found that 53% of spirometry maneuvers failed to reach a plateau despite encouragement by trained operators and long FETs ( 72 ). However, in another study, 90% of patients with severe lung function impairment were able to meet the criteria ( 81 ). Other large adult population studies found that more than 95% of subjects who expired for longer than 6 seconds achieved a plateau ( 82 , 83 ).…”

Section: Fev 1 and Fvc Maneuvermentioning

confidence: 97%

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

Graham¹,

Steenbruggen²,

Miller³

et al. 2019

Am J Respir Crit Care Med

2,483

1,736

View full text Add to dashboard Cite

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.

show abstract

Section: Fev 1 and Fvc Maneuvermentioning

confidence: 97%

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

Graham¹,

Steenbruggen²,

Miller³

et al. 2019

Am J Respir Crit Care Med

2,483

1,736

View full text Add to dashboard Cite

show abstract

“…Primarily, the results of our study show that implementation of such a pathway into the infrastructure of the cardiology department is feasible, with AF nurses being able to supervise the handheld (micro) spirometry and achieving valid results according to device standards in 89% of patients, comparable to conventional spirometry. 21 , 35 , 36 Moreover, airflow limitation was identified in one out of five patients.…”

Section: Discussionmentioning

confidence: 93%

Implementation of a screening and management pathway for chronic obstructive pulmonary disease in patients with atrial fibrillation

van der Velden,

Hereijgers,

Arman

et al. 2023

Europace

View full text Add to dashboard Cite

Background and aims Chronic obstructive pulmonary disease (COPD) negatively impacts the efficacy of heart rhythm control treatments in patients with atrial fibrillation (AF). Although COPD is recognized as a risk factor for AF, practical guidance about how and when to screen for COPD is not available. Herein, we describe the implementation of an integrated screening and management pathway for COPD into the existing pre-ablation work-up in an AF outpatient clinic infrastructure. Methods Consecutive unselected patients accepted for AF catheter ablation in the Maastricht University Medical Center + were prospectively screened for airflow limitation using handheld (micro)spirometry at the pre-ablation outpatient clinic supervised by an AF nurse. Patients with results suggestive of airflow limitation were offered referral to the pulmonologist. Results Handheld (micro)spirometry was performed in 232 AF patients, which provided interpretable results in 206 (88.8%) patients. Airflow limitation was observed in 47 patients (20.3%). Out of these 47 patients, 29 (62%) opted for referral to the pulmonologist. The primary reason for non-referral was low perceived symptom burden. Using this screening strategy 17 (out of 232; 7.3%) ultimately received a diagnosis of chronic respiratory disease, either COPD or asthma. Conclusion A COPD care pathway can successfully be embedded in an existing AF outpatient clinic infrastructure, using (micro)spirometry and remote analysis of results. Although 1 out of 5 patients had results suggestive of an underlying chronic respiratory disease, only 62% of these patients opted for referral. Preselection of patients as well as patient education might increase the diagnostic yield and requires further research.

show abstract

“…Further studies can examine if spirometry interpretation criteria can be re-evaluated to accommodate suboptimal performance during pregnancy such as exploring the potential of using grade D under certain conditions. Although disregarded, the potential of lowering quality control criteria has been evaluated previously (20).…”

Section: Discussionmentioning

confidence: 99%

Spirometry performance quality and lung function pattern during pregnancy; should testing conditions and interpretation criteria be re-evaluated?

Ruhighira

Mashili

Tungu

et al. 2023

Preprint

View full text Add to dashboard Cite

Introduction Despite the prevalence of respiratory disorders in the gravid state, and the crucial role of spirometry in respiratory medicine, its utility for assessing lung function during pregnancy remains infrequent. Putative reasons for this include reservations regarding spirometry performance and its potential influence on test outcomes, although the literature documenting such concerns is insufficient. This study sought to evaluate whether variations in spirometry test performance could impact the diagnosis of pulmonary function patterns throughout gestation. Methods We used spirometry data from a cross-sectional study of 120 pregnant and 114 non-pregnant women who underwent spirometry with uniform instructions given to all subjects. Data were subjected to chi-square testing and subsequently evaluated through logistic regression analysis. Results The acceptable performance rate among pregnant participants was 77.3%, with the most common quality grade being C (37.5%). Pregnant individuals exhibited 2.1 times the odds of achieving a B grade (p=0.037, 95% CI=1.0-4.2) and 4.1 times the odds of achieving an F grade (p=0.02, 95% CI=1.6-9.9) instead of an A grade. Additionally, they manifested 2.9 times the odds of generating unsatisfactory performance (p=0.007, 95% CI=1.3-6.1) compared to non-pregnant participants. Also, pregnant participants displayed 2.5 times the odds of exhibiting a restrictive pattern (p=0.021, 95% CI=1.1-5.7); but pattern classification was not associated with quality grades. Conclusion Despite the higher likelihood of suboptimal spirometry quality, the observed pattern classification remains as expected physiologically, suggesting that spirometry is still a valid tool for assessing lung function in pregnancy.

show abstract

Spirometry Quality in Adults With Very Severe Lung Function Impairment

Cited by 6 publications

References 16 publications

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

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

Implementation of a screening and management pathway for chronic obstructive pulmonary disease in patients with atrial fibrillation

Spirometry performance quality and lung function pattern during pregnancy; should testing conditions and interpretation criteria be re-evaluated?

Contact Info

Product

Resources

About