From the Guidelines
Pulmonary function tests are indicated for a wide range of diagnostic, monitoring, and evaluative purposes, including assessing symptoms, measuring disease effect, screening for pulmonary disease, and evaluating pre-operative risk, as outlined in the standardisation of spirometry guidelines 1. The indications for pulmonary function tests can be broadly categorized into several areas, including:
- Diagnostic purposes, such as evaluating symptoms, signs, or abnormal laboratory tests, measuring the effect of disease on pulmonary function, and screening individuals at risk of having pulmonary disease 1
- Monitoring purposes, such as assessing therapeutic intervention, describing the course of diseases that affect lung function, and monitoring people exposed to injurious agents 1
- Disability/impairment evaluations, including assessing patients as part of a rehabilitation programme, assessing risks as part of an insurance evaluation, and assessing individuals for legal reasons 1
- Public health purposes, including epidemiological surveys, derivation of reference equations, and clinical research 1 Some specific examples of indications for pulmonary function tests include:
- Evaluating respiratory symptoms such as dyspnea, chronic cough, wheezing, or exercise intolerance
- Assessing disease severity and determining treatment effectiveness in patients with respiratory conditions such as asthma, chronic obstructive pulmonary disease (COPD), interstitial lung disease, pulmonary fibrosis, cystic fibrosis, and neuromuscular disorders affecting respiration
- Preoperative evaluation to assess surgical risk in patients undergoing thoracic or upper abdominal surgery, especially those with known respiratory disease or smoking history
- Evaluating occupational exposures to respiratory irritants and monitoring potential medication-induced lung toxicity from drugs like amiodarone, bleomycin, or methotrexate 1 The most common pulmonary function tests include spirometry, lung volume measurements, diffusion capacity testing, and bronchodilator response testing, with each providing specific information about different aspects of respiratory function.
From the Research
Indications for Pulmonary Function Tests
The indications for pulmonary function tests include:
- Diagnosis and management of patients with suspected or previously diagnosed respiratory disease 2
- Monitoring response to treatment and guiding decisions regarding further treatment and intervention 2
- Differentiating between various obstructive lung diseases such as asthma, COPD, and asthma-COPD overlap 3
- Evaluating patients with symptoms of dyspnea to quantify the symptom and diagnose respiratory and nonrespiratory disorders 4
- Management of interstitial lung diseases, including diagnosis, staging, prognostication, and follow-up 5
- Comprehensive assessment and individualized management of chronic obstructive pulmonary disease, including diagnosis, assessment of severity, and indication for and responses to pharmacologic and nonpharmacologic interventions 6
Specific Conditions
Pulmonary function tests are useful in the management of various respiratory conditions, including:
- Asthma 3, 6
- COPD 3, 6
- Asthma-COPD overlap 3
- Cystic fibrosis 3
- Interstitial lung disease 5
- Chronic obstructive pulmonary disease 6
Test Interpretation
The interpretation of pulmonary function tests requires knowledge of respiratory physiology 2 and can provide valuable information for the diagnosis and management of various respiratory conditions 4.