General considerations for lung function testing

SERIES “ATS/ERS TASK FORCE: STANDARDISATION OF LUNG FUNCTION TESTING” Edited by V. Brusasco, R. Crapo and G. Viegi Number 1 in this Series ⇓In preparing the joint statements on lung function testing for the American Thoracic Society (ATS) and the European Respiratory Society (ERS), it was agreed by the working party that the format of the statements should be modified so that they were easier to use by both technical and clinical staff. This statement contains details about procedures that are common for many methods of lung function testing and, hence, are presented on their own. A list of abbreviations used in all the documents is also included as part of this statement. All terms and abbreviations used here are based on a report of the American College of Chest Physicians/ATS Joint Committee on Pulmonary Nomenclature 1. The metrology definitions agreed by the International Standards Organization (ISO) are recommended 2 and some important terms are defined as follows. Accuracy is the closeness of agreement between the result of a measurement and the conventional true value. Repeatability is the closeness of agreement between the results of successive measurements of the same item carried out, subject to all of the following conditions: same method, same observer, same instrument, same location, same condition of use, and repeated over a short space of time. In previous documents, the term reproducibility was used in this context, and this represents a change towards bringing this document in line with the ISO. Reproducibility is the closeness of agreement of the results of successive measurements of the same item where the individual measurements are carried out with changed conditions, such as: method of measurement, observer, instrument, location, conditions of use, and time. Thus, if a technician tests a subject several times, this is looking at the …

[1]  J. Hankinson,et al.  Interpretative strategies for lung function tests , 2005, European Respiratory Journal.

[2]  G. Viegi,et al.  Standardisation of the measurement of lung volumes , 2005, European Respiratory Journal.

[3]  M. Miller,et al.  Troponin T in pulmonary embolism , 2003, Thorax.

[4]  C. Leach,et al.  Lung deposition of hydrofluoroalkane-134a beclomethasone is greater than that of chlorofluorocarbon fluticasone and chlorofluorocarbon beclomethasone : a cross-over study in healthy volunteers. , 2002, Chest.

[5]  L. Forkert,et al.  Response of lung volumes to inhaled salbutamol in a large population of patients with severe hyperinflation. , 2002, Chest.

[6]  M. Miller,et al.  Recording flow in the first second of a maximal forced expiratory manoeuvre: influence of frequency content , 2002, European Respiratory Journal.

[7]  B. Dautzenberg.  [Prevention of nosocomial infection during nebulization and spirometry]. , 2001, Revue de pneumologie clinique.

[8]  W T Ambrosius,et al.  Spirometric pulmonary function in healthy preschool children. , 2001, American journal of respiratory and critical care medicine.

[9]  C. Bucca,et al.  Effect of edentulism on spirometric tests. , 2001, American journal of respiratory and critical care medicine.

[10]  R. Crapo,et al.  FEV(6) is an acceptable surrogate for FVC in the spirometric diagnosis of airway obstruction and restriction. , 2000, American journal of respiratory and critical care medicine.

[11]  M. Miller,et al.  Peak expiratory flow profiles delivered by pump systems. Limitations due to wave action. , 2000, American journal of respiratory and critical care medicine.

[12]  Townsend Mc,et al.  ACOEM position statement. Spirometry in the occupational setting. American College of Occupational and Environmental Medicine. , 2000 .

[13]  P. Wollmer,et al.  Changes in transfer factor of the lung in response to bronchodilatation. , 2000, Clinical physiology.

[14]  M. Townsend.  ACOEM position statement. Spirometry in the occupational setting. American College of Occupational and Environmental Medicine. , 2000, Journal of occupational and environmental medicine.

[15]  D. O’Donnell,et al.  Spirometric correlates of improvement in exercise performance after anticholinergic therapy in chronic obstructive pulmonary disease. , 1999, American journal of respiratory and critical care medicine.

[16]  M. Newhouse.  Asthma therapy with aerosols: are nebulizers obsolete? A continuing controversy. , 1999, The Journal of pediatrics.

[17]  R. Pierce.  Infection control in the respiratory laboratory: risk, costs, expediency. , 1999, Australian and New Zealand journal of medicine.

[18]  A. Aggarwal,et al.  Interpreting spirometric data: impact of substitution of arm span for standing height in adults from North India. , 1999, Chest.

[19]  D. Johns,et al.  A cost-analysis of two approaches to infection control in a lung function laboratory. , 1999, Australian and New Zealand journal of medicine.

[20]  J L Hankinson,et al.  Spirometric reference values from a sample of the general U.S. population. , 1999, American journal of respiratory and critical care medicine.

[21]  A. Coates,et al.  Drug administration by jet nebulization , 1998, Pediatric pulmonology.

[22]  R. Pellegrino,et al.  Assessing the reversibility of airway obstruction. , 1998, Chest.

[23]  M. Miller,et al.  The rise and dwell time for peak expiratory flow in patients with and without airflow limitation. , 1998, American journal of respiratory and critical care medicine.

[24]  A. Coates,et al.  A comparison of the availability of tobramycin for inhalation from vented vs unvented nebulizers. , 1998, Chest.

[25]  Shumei S. Guo,et al.  Stature prediction equations for elderly non-Hispanic white, non-Hispanic black, and Mexican-American persons developed from NHANES III data. , 1998, Journal of the American Dietetic Association.

[26]  A. Coates,et al.  Redefining end of test (EOT) criteria for pulmonary function testing in children. , 1997, American journal of respiratory and critical care medicine.

[27]  A. Coates,et al.  Measurement of lung volumes in humans: review and recommendations from an ATS/ERS workshop. , 1997, The European respiratory journal.

[28]  J. Wildhaber,et al.  Aerosol delivery to wheezy infants: A comparison between a nebulizer and two small volume spacers , 1997, Pediatric pulmonology.

[29]  R. Pellegrino,et al.  Lung hyperinflation and flow limitation in chronic airway obstruction. , 1997, The European respiratory journal.

[30]  J. Hankinson,et al.  Method to produce American Thoracic Society flow-time waveforms using a mechanical pump. , 1997, The European respiratory journal.

[31]  O F Pedersen,et al.  Peak expiratory flow: conclusions and recommendations of a Working Party of the European Respiratory Society. , 1997, The European respiratory journal. Supplement.

[32]  J. Roca,et al.  Bacterial colonization as a potential source of nosocomial respiratory infections in two types of spirometer. , 1996, The European respiratory journal.

[33]  J. Parker,et al.  Arm span-height relationships in patients referred for spirometry. , 1996, American journal of respiratory and critical care medicine.

[34]  A. Tal,et al.  Deposition pattern of radiolabeled salbutamol inhaled from a metered-dose inhaler by means of a spacer with mask in young children with airway obstruction. , 1996, The Journal of pediatrics.

[35]  M. Miller,et al.  Peak expiratory flow and the resistance of the mini-wright peak flow meter. , 1996, The European respiratory journal.

[36]  J. Leeming,et al.  The efficacy of filters used in respiratory function apparatus. , 1995, The Journal of hospital infection.

[37]  J. Stocks,et al.  Respiratory function measurements in infants: symbols, abbreviations and units. , 1995, The European respiratory journal.

[38]  Effect of a microaerosol barrier filter on the measurement of lung function. , 1995, Chest.

[39]  J. Stocks,et al.  Reference values for residual volume, functional residual capacity and total lung capacity. ATS Workshop on Lung Volume Measurements. Official Statement of The European Respiratory Society. , 1995, The European respiratory journal.

[40]  R. Pistelli,et al.  Effects of a filter at the mouth on pulmonary function tests. , 1995, The European respiratory journal.

[41]  Shumei S. Guo,et al.  Prediction of stature from knee height for black and white adults and children with application to mobility-impaired or handicapped persons. , 1994, Journal of the American Dietetic Association.

[42]  P. Enright,et al.  Volume spirometers need automated internal temperature sensors. , 1994, American journal of respiratory and critical care medicine.

[43]  C. F. von Reyn,et al.  Isolation of Mycobacterium avium complex from water in the United States, Finland, Zaire, and Kenya , 1993, Journal of clinical microbiology.

[44]  M. Miller,et al.  Expired air temperature at the mouth during a maximal forced expiratory manoeuvre. , 1993, The European respiratory journal.

[45]  P. Sly,et al.  Determination of peak expiratory flow. , 1993, The European respiratory journal.

[46]  J. Milic-Emili,et al.  Dependence of maximal flow-volume curves on time course of preceding inspiration. , 1993, Journal of applied physiology.

[47]  D. Laskowski,et al.  Trial of standard versus modified expiration to achieve end-of-test spirometry criteria. , 1993, The American review of respiratory disease.

[48]  J. Roca,et al.  Standardization of the measurement of transfer factor (diffusing capacity) , 1993, European Respiratory Journal.

[49]  R. Peslin,et al.  Symbols, abbreviations and units. Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. , 1993, The European respiratory journal. Supplement.

[50]  R. Peslin,et al.  Symbols, abbreviations and units , 1993, European Respiratory Journal.

[51]  J. Leeming,et al.  Use of filters for the control of cross-infection during pulmonary function testing. , 1993, The Journal of hospital infection.

[52]  J. Roca,et al.  Standardization of the measurement of transfer factor (diffusing capacity). Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. , 1993, The European respiratory journal. Supplement.

[53]  J E Cotes,et al.  Lung volumes and forced ventilatory flows , 1993, European Respiratory Journal.

[54]  J E Cotes,et al.  Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. , 1993, The European respiratory journal. Supplement.

[55]  A. Miller,et al.  Lung function testing: selection of reference values and interpretative strategies. , 1992, The American review of respiratory disease.

[56]  P. Hunter,et al.  Laboratory evaluation of a filter for the control of cross-infection during pulmonary function testing. , 1992, The Journal of hospital infection.

[57]  A. Buist,et al.  Spirometry in the Lung Health Study. 1. Methods and quality control. , 1991, The American review of respiratory disease.

[58]  J. Hankinson,et al.  Acceptability and reproducibility criteria of the American Thoracic Society as observed in a sample of the general population. , 1991, The American review of respiratory disease.

[59]  W. Rutala,et al.  Infection risks associated with spirometry. , 1991, Infection control and hospital epidemiology.

[60]  A. Buist,et al.  Spirometry in the Lung Health Study , 1991 .

[61]  R. Viggiano,et al.  Effect of mild-to-moderate airflow limitation on exercise capacity. , 1991, Journal of applied physiology.

[62]  R M Gardner,et al.  Performance evaluation of contemporary spirometers. , 1990, Chest.

[63]  S. Clarke,et al.  Pressurised aerosol deposition in the human lung with and without an "open" spacer device. , 1989, Thorax.

[64]  D. Cramer,et al.  Lung function testing and AIDS. , 1989, Respiratory medicine.

[65]  A Y Tsang,et al.  Concentration of Mycobacterium avium by hospital hot water systems. , 1988, JAMA.

[66]  M. Botman,et al.  Contamination of small-volume medication nebulizers and its association with oropharyngeal colonization. , 1987, The Journal of hospital infection.

[67]  A. Buist.  Standardization of spirometry. , 1987, The American review of respiratory disease.

[68]  J. Hankinson,et al.  Pulmonary function laboratory personnel qualifications. , 2015, The American review of respiratory disease.

[69]  J. Hankinson,et al.  Quality assurance in pulmonary function laboratories. , 2015, The American review of respiratory disease.

[70]  G. Viegi,et al.  Reference values for vital capacity and flow-volume curves from a general population study. , 1986, Bulletin europeen de physiopathologie respiratoire.

[71]  M. R. Miller,et al.  Linearity and temperature control of the Fleisch pneumotachograph. , 1986, Journal of applied physiology.

[72]  W. Martone,et al.  Infection Control in Pulmonary Function Laboratories , 1985, Infection Control.

[73]  M. C. Townsend.  Spirometric forced expiratory volumes measured in the standing versus the sitting posture. , 2015, The American review of respiratory disease.

[74]  M. Younes,et al.  Respiratory mechanics and breathing pattern during and following maximal exercise. , 1984, Journal of applied physiology: respiratory, environmental and exercise physiology.

[75]  M. Corey,et al.  Pseudomonas cepacia infection in cystic fibrosis: an emerging problem. , 1984, The Journal of pediatrics.

[76]  A. Morris.  Clinical pulmonary function testing : a manual of uniform laboratory procedures , 1984 .

[77]  M. Miller,et al.  The effect of temperature on recording spirograms. , 1983, The American review of respiratory disease.

[78]  J. Hankinson,et al.  Dynamic BTPS correction factors for spirometric data. , 1983, Journal of applied physiology: respiratory, environmental and exercise physiology.

[79]  J. Hankinson,et al.  Spirometry: what paper speed? , 1983, Chest.

[80]  W. Perks,et al.  Effects of temperature on Vitalograph spirometer readings. , 1983, Thorax.

[81]  F. Speizer,et al.  Spirometry in children. Methodology for obtaining optimal results for clinical and epidemiologic studies. , 1983, The American review of respiratory disease.

[82]  R M Gardner,et al.  Standard waveforms for spirometer testing. , 2015, The American review of respiratory disease.

[83]  R. Hazaleus,et al.  Tuberculin skin test conversion from exposure to contaminated pulmonary function testing apparatus. , 1981, Respiratory care.

[84]  R M Gardner,et al.  Evaluating commercially available spirometers. , 2015, The American review of respiratory disease.

[85]  A. Renzetti.  Standardization of spirometry. , 2015, The American review of respiratory disease.

[86]  F. Speizer,et al.  Spirometry for an epidemiologic study: deriving optimum summary statistics for each subject. , 1978, Bulletin europeen de physiopathologie respiratoire.

[87]  J. Eichhorn,et al.  Contamination of Medical Gas and Water Pipelines in a New Hospital Building , 1977, Anesthesiology.

[88]  B. Burrows,et al.  Pulmonary terms and symbols. A report of the ACCP-STS Joint Committee on Pulmonary Nomenclature. , 1975, Chest.

[89]  W. Warwick,et al.  Water vapour pressure in expired air. , 1974, Respiration; international review of thoracic diseases.

[90]  W. F. Miller,et al.  Relationships between maximal breathing capacity and timed expiratory capacities , 1959 .

[91]  D. L. Fry,et al.  Harmonic content of certain respiratory flow phenomena of normal individuals. , 1957, Journal of applied physiology.

[92]  P. Cole.  Recordings of Respiratory Air Temperature , 1954, The Journal of Laryngology & Otology.

[93]  lhealtlhy youin-g,et al.  Hospital for Sick Children , 1857, British medical journal.