The Role of Pulmonary Function Testing in the Diagnosis and Management of COPD.

Pulmonary function testing (PFT) has a long and rich history in the definition, diagnosis, and management of COPD. For decades, spirometry has been regarded as the standard for diagnosing COPD; however, numerous studies have shown that COPD symptoms, pathology, and associated poor outcomes can occur, despite normal spirometry. Diffusing capacity and imaging studies have called into question the need for spirometry to put the "O" (obstruction) in COPD.

Real-world diffusing capacity simulation data: how well do they fit current European Respiratory Society/American Thoracic Society acceptability criteria?

https://bit.ly/3Z0YoZL.

Official ERS technical standard: Global Lung Function Initiative reference values for static lung volumes in individuals of European ancestry.

Background: Measurement of lung volumes across the life course is critical to the diagnosis and management of lung disease. The aim of the study was to use the Global Lung Function Initiative methodology to develop all-age multi-ethnic reference equations for lung volume indices determined using body plethysmography and gas dilution techniques.

Methods: Static lung volume data from body plethysmography and gas dilution techniques from individual, healthy participants were collated.

Weight-based reference equations for the 6-min walk test can be misleading in obese patients.

https://bit.ly/2wE9Sdn.

Pulmonary Function Reference Equations: A Brief History to Explain All the Confusion.

Predicted values for pulmonary function tests differ significantly from the reference values used for many other diagnostic tests. Historically, simple equations using age, height, and sex were used to "predict" normal lung function. However, these multiple factors interact in complex ways to determine what the expected lung function values are in healthy subjects.

Exercise-Induced Oxygen Desaturation during the 6-Minute Walk Test.

The 6-minute walk test (6MWT) is not intended to document oxygen (O) desaturation during exertion but is often used for this purpose. Because of this, it only has modest reproducibility in determining the need for ambulatory O therapy in patients with cardiopulmonary disease. The diagnostic and prognostic value of detecting exertional O desaturation is still unknown.

Should spirometer quality control be treated like other laboratory devices?

http://ow.ly/Pqdq30nwAmb.

Office Spirometry in Primary Care for the Diagnosis and Management of COPD: National Lung Health Education Program Update.

The use of office spirometry was recommended by the National Lung Health Education Program (NLHEP) consensus conference in 1999 for detection and management of COPD. Since that time, spirometry utilization has increased, but its role in the diagnosis of COPD is still evolving. This update reviews the role of spirometry for screening and case finding in COPD as well as for asthma.

The Global Lung Function Initiative (GLI) Network: bringing the world's respiratory reference values together.

Unlabelled: The Global Lung Function Initiative (GLI) Network has become the largest resource for reference values for routine lung function testing ever assembled. This article addresses how the GLI Network came about, why it is important, and its current challenges and future directions. It is an extension of an article published in in 2013 [1], and summarises recent developments and the future of the GLI Network.

Bronchodilator Response in FVC Is Larger and More Relevant Than in FEV in Severe Airflow Obstruction.

Background: Recommendations on interpreting tests of bronchodilator responsiveness (BDR) are conflicting. We investigated the dependence of BDR criteria on sex, age, height, ethnicity, and severity of respiratory impairment.

Methods: BDR test data were available from clinical patients in the Netherlands, New Zealand, and the United States (n = 15,278; female subjects, 51.

Residual Volume and Total Lung Capacity to Assess Reversibility in Obstructive Lung Disease.

Background: Reversibility of obstructive lung disease is traditionally defined by changes in FEV or FVC in response to bronchodilators. These may not fully reflect changes due to a reduction in hyperinflation or air-trapping, which have important clinical implications. To date, only a handful of studies have examined bronchodilators' effect on lung volumes.

A retrospective study of two populations to test a simple rule for spirometry.

Background: Chronic lung disease is common and often under-diagnosed.

Methods: To test a simple rule for conducting spirometry we reviewed spirograms from two populations, occupational medicine evaluations (OME) conducted by Saint Louis and Wake Forest Universities at 3 sites (n = 3260, mean age 64.14 years, 95 % CI 58.

Aerosol Use in the Pulmonary Function Lab.

Aerosolized medications are frequently used in the pulmonary function laboratory. The 2 most common implementations are bronchodilators and bronchial challenge agents. Bronchodilator administration is not well standardized, largely because of the various methods of delivery available for clinical practice.

Pulmonary function testing.

Pulmonary function testing is often considered the basis for diagnosis in many categories of pulmonary disease. Although most of the testing methodologies are well established and widely employed, there are still many questions regarding how tests should be performed, how to ensure that reliable data are produced, what reference values and rules should be used, and how pulmonary function tests (PFTs) should be interpreted to best support clinical decision making. This conference was organized around a set of questions aimed at many of these issues.