Pulmonary function testing in asthma
- Charles G Irvin, PhD, FERS
Charles G Irvin, PhD, FERS
- University of Vermont Department of Medicine
The "classic" signs and symptoms of asthma are intermittent dyspnea, cough, and wheezing. While typical of asthma, these symptoms are nonspecific, making it difficult to distinguish asthma from other respiratory diseases. The definitive diagnosis of asthma requires the history or presence of respiratory symptoms consistent with asthma, combined with the demonstration of variable expiratory airflow obstruction [1,2].
The use of pulmonary function testing in the diagnosis of asthma will be reviewed here. The diagnosis of asthma and the performance and interpretation of pulmonary function tests are discussed separately. (See "Diagnosis of asthma in adolescents and adults" and "Overview of pulmonary function testing in adults" and "Office spirometry".)
TESTS FOR THE DIAGNOSIS OF ASTHMA
The diagnosis of asthma is based upon a compatible clinical history and characteristic findings from a series of pulmonary function tests (PFTs) [1-3]. An approach to the use of PFTs in the diagnosis of asthma is provided in the algorithm (algorithm 1). The clinical features and diagnosis of asthma are discussed separately. (See "Diagnosis of asthma in adolescents and adults", section on 'Clinical features'.)
The specific PFTs are selected to identify the characteristic features of asthma, which include [1,2]:
●Variable airflow limitation, which can be either circadian or episodic in nature
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- TESTS FOR THE DIAGNOSIS OF ASTHMA
- Flow-volume relationships
- Bronchodilator responses
- Peak expiratory flow
- Bronchoprovocation challenge
- Fraction of exhaled nitric oxide
- MONITORING ASTHMA
- EFFECT OF ASTHMA ON OTHER PULMONARY FUNCTION TESTS
- Lung volumes
- - Overview
- - Residual volume
- - Functional residual capacity
- - Total lung capacity
- Diffusing capacity
- ADDITIONAL TESTING IN PATIENTS WITH COMORBID DISEASE
- RESEARCH TOOLS FOR ASSESSMENT OF AIRFLOW LIMITATION