Office spirometry

Abstract

Chronic lung diseases carry a significant amount of morbidity and mortality. Obstructive lung diseases in particular are the fourth leading cause of death in the United States. Easily implemented in the primary care office, spirometry is a portable and useful tool to diagnose and monitor patients with chronic lung disease. The main goals of office spirometry are to measure a patient's ability to exhale forcefully, and to distinguish obstructive from restrictive lung disease. Indications include to evaluate the signs or symptoms of possible lung disease, to assess effectiveness of treatment for lung disease, and to follow-up or monitor progression of lung disease in primary care or in occupational health patients. It may also be used to assess a patient's baseline lung function if needed for insurance purposes or by some employers as part of pre-employment screening. Basic requirements to perform office spirometry are a well-trained operator, a suitable patient, and spirometry equipment that meets or exceeds the American Thoracic Society's standards for office spirometers. Interpretation of spirometry results should always be done in the context of the patient's clinical picture and never as isolated values that may or may not fall within the range of normal. Results obtained in the office can be analyzed to determine if the patient has obstructive, restrictive, or mixed lung disease, or if any airway obstructions are present. The test can also be repeated after the administration of a bronchodilator to determine if significant bronchodilation is present. Spirometry data can be monitored over time to optimize therapy and assess progression of patients with chronic lung disease.