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Overview of pulmonary function testing in adults

Meredith C McCormack, MD, MHS
Section Editor
James K Stoller, MD, MS
Deputy Editor
Helen Hollingsworth, MD


Evaluation of pulmonary function is important in many clinical situations, both when the patient has a history or symptoms suggestive of lung disease and when risk factors for lung disease are present, such as occupational exposure to agents with known lung toxicity [1].

The European Respiratory Society and the American Thoracic Society have published guidelines for the measurement and interpretation of pulmonary function tests (PFTs) [2-5].

An overview of pulmonary function testing will be presented here, summarizing the types of PFTs and their indications. Specific aspects of pulmonary function testing are discussed elsewhere. (See "Office spirometry" and "Reference values for pulmonary function testing" and "Diffusing capacity for carbon monoxide" and "Use of pulmonary function testing in the diagnosis of asthma" and "Bronchoprovocation testing" and "Overview of pulmonary function testing in children".)


The major types of pulmonary function tests (PFTs) are spirometry, spirometry before and after a bronchodilator, lung volumes, and quantitation of diffusing capacity for carbon monoxide. Additional PFTs, such as measurement of maximal respiratory pressures, flow-volume loops, submaximal exercise testing, and bronchoprovocation challenge, are useful in specific clinical circumstances (table 1).

Spirometry — Spirometry, the most readily available and useful pulmonary function test, measures the volume of air exhaled at specific time points during a forceful and complete exhalation after a maximal inhalation. The total exhaled volume, known as the forced vital capacity (FVC), the volume exhaled in the first second, known as the forced expiratory volume in one second (FEV1), and their ratio (FEV1/FVC) are the most important variables reported. The test takes 10 to 15 minutes and carries minimal risk (eg, rarely syncope). The technique for performing spirometry and interpretation of results are described separately. (See "Office spirometry" and "Flow-volume loops".)


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Literature review current through: Oct 2015. | This topic last updated: Apr 17, 2015.
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