What is the interpretation and management of spirometry results showing an FEV1/FVC ratio of 82, FEV1 of 108, FVC of 109, and PEF of 80?

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Spirometry Interpretation: Normal Lung Function

Your spirometry results are completely normal and require no intervention or further testing. 1, 2

Primary Pattern Analysis

Your results show:

  • FEV1/FVC ratio of 82% is well above the threshold for obstruction (>70% or above the 5th percentile), indicating normal airway caliber 1, 2
  • FEV1 of 108% predicted is above normal (≥80% is normal), indicating excellent lung function 3, 2
  • FVC of 109% predicted is above normal (≥80% is normal), indicating excellent lung capacity 1, 2
  • PEF of 80% is within normal limits, though slightly lower than your volume parameters, which can occur with normal variation in effort 1

What This Means

  • No obstructive pattern: Your FEV1/FVC ratio of 82% excludes COPD, asthma, or any other obstructive lung disease 3, 2
  • No restrictive pattern: Both your FEV1 and FVC exceed 80% predicted and are proportionally normal, excluding restrictive lung disease 3, 1
  • No mixed pattern: The combination of normal ratio and normal volumes rules out combined obstruction and restriction 3, 2

Clinical Implications

  • No further testing needed: Lung volume measurements (TLC, RV) are not indicated when spirometry is entirely normal 1, 4
  • No bronchodilator testing needed: With normal baseline spirometry, there is no indication for reversibility testing 2, 5
  • Excellent prognosis: Normal spirometry is associated with standard population mortality and morbidity risks 6

Common Pitfalls to Avoid

  • Don't over-interpret the PEF: A PEF of 80% with normal FEV1 (108%) and FVC (109%) represents normal variation and does not indicate disease 3, 1
  • Don't pursue unnecessary testing: The negative predictive value of normal spirometry is >97% for excluding lung disease, making additional pulmonary function testing unnecessary in the absence of specific clinical concerns 4

References

Guideline

Spirometry Interpretation of Restrictive Patterns

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Interpreting Spirometry for Lung Disease Diagnosis

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Office Spirometry: Indications and Interpretation.

American family physician, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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