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ATS, 2005
SPIROMETRY AND ASTHMA
At initial assessment
After treatment initiated and symptoms and
PEF have stabilized
During periods of progressive or prolonged
asthma control
At least every 1-2 years: more frequently
depending on response to therapy
WHY NECESSARY?
o To evaluate symptoms, signs or abnormal laboratory
tests
o To measure the effect of disease on pulmonary
function
o To screen individuals at risk of having pulmonary
disease
o To assess pre-operative risk
o To assess prognosis
o To assess health status before beginning strenuous
physical activity programs
ATS, 2005
SPIROMETRY VERSUS PEAK FLOW
Recommended over peak flow meter measurements in
clinician’s office.
Variability in predicted PEF reference values.
EPR 3, 2007
WHY MEASURE?
o Some patients are “poor perceivers.”
o Perception of obstruction variable and spirometry
reveals obstruction more severe.
o Family members “underestimate” severity of
symptoms.
o Objective assessment of degree of airflow obstruction.
o Pulmonary function measures don’t always correlate
with symptoms.
o Comprehensive assessment of asthma.
Vital Capacity:
o Maximum amount of air emptied from lungs
Effort dependent!
The top of the blast
ATS, 2005
SUMMARY
Pulmonary functions are important
o Gold standard used to confirm diagnosis of
asthma (≥ 12% FEV1, ≥ 200 ml)
o Determine the degree of obstruction
o Determine severity
o To assess one aspect of response to therapy
o To monitor for future remodeling
SUPPLEMENTAL SLIDES
BRONCHODILATOR RESPONSE
FEV1 may improve within about 10 minutes of
using inhaled bronchodilator
If reverses by ≥ 12% “reversibility” or “bronchial
hyper-responsiveness” has been
demonstrated
If reversible, suggests asthma