What do these spirometry results indicate?

Normal Spirometry Results

These spirometry results are entirely normal and do not indicate any respiratory disease or airflow obstruction. All key parameters are within or above normal limits, and no intervention is needed.

Key Findings Analysis

Primary Diagnostic Parameters

• FEV1/FVC ratio is 109% of predicted (well above the 0.70 threshold), which definitively rules out obstructive lung disease such as COPD or asthma 1
• FEV1 is 112% of predicted, indicating excellent airflow with no obstruction 2
• FVC is 102% of predicted, showing normal lung volumes 2

Flow-Volume Parameters

• Mid-expiratory flows (FEF 25-75%) are 153% of predicted, which is markedly elevated and indicates excellent small airway function 2
• FEF 50% and FEF 75% are 132% and 191% of predicted respectively, demonstrating robust expiratory flow throughout the entire forced expiration 2
• These elevated mid-expiratory flows further confirm the absence of any small airway disease 2

Clinical Interpretation

No respiratory pathology is present based on these results. The American Thoracic Society emphasizes that spirometry results must be interpreted in the context of symptoms, risk factors, and clinical presentation 2. In this case:

• The FEV1/FVC ratio >0.70 excludes obstructive disease (COPD, asthma) 1
• The normal-to-elevated FVC excludes restrictive disease 2
• The supranormal mid-expiratory flows indicate no small airway dysfunction 2

Expiration Time Consideration

The expiration time of 2.75 seconds is slightly shorter than the ideal 6 seconds, but this is not clinically significant given that:

• FVC and FEV1 are both normal-to-elevated 2
• The FEV1/FVC ratio is clearly normal 2
• All flow parameters are excellent 2

Clinical Recommendations

No treatment, monitoring, or further testing is indicated. The American College of Physicians explicitly recommends against treating asymptomatic individuals with normal spirometry, regardless of risk factors 1, 3.

• If the patient is symptomatic despite normal spirometry, consider alternative diagnoses unrelated to airflow obstruction 2
• Routine periodic spirometry is not recommended in asymptomatic individuals with normal baseline results 1
• If the patient is a smoker, focus on smoking cessation counseling (though spirometry results do not independently improve cessation rates) 1

Important Caveats

• These results assume the spirometry met quality standards (grades A, B, or C per American Thoracic Society criteria) 2
• Ethnic-specific reference values should have been used if applicable 2
• Normal spirometry does not exclude all lung diseases (e.g., early interstitial lung disease, pulmonary vascular disease) but does exclude clinically significant obstructive or restrictive ventilatory defects 2