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End of Forced Expiration (EOFE)
Some standards stress the importance of a maximal inspiration after the forced expiration.
As such, the
end of forced expiration
(EOFE) is not the end of the maneuver, and hence the
term EOFE is used.
Recognizing a satisfactory EOFE is important to ensure that a true FVC has been achieved.
Achieving one of the following three recommended indicators of EOFE is required:
1. There is less than a 0.025 L change in volume for at least 1 second (a “plateau”).
OR
2. The patient has achieved an FET of 15 seconds.
OR
3. FVC is within the repeatability tolerance of or is greater than the largest prior
observed FVC *
* Occurs when the patient cannot expire long enough to achieve a plateau (e.g., children
with high elastic recoil or patients with restrictive lung disease) or when the patient inspires
or comes off the mouthpiece before a plateau. For within-maneuver acceptability, the FVC
must be greater than or within the repeatability tolerance of the largest FVC observed before
this maneuver within the current prebronchodilator or the current post-bronchodilator testing
set.
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The Maximum Voluntary Ventilation (MVV) Test Breathing Maneuver:
1. Ensure that the device is connected. Select the MVV test mode and the test screen
will appear.
2. Enter the required ambient conditions (makes sure you entered the correct values as
the measurement may be significantly affected by a wrong value) like temperature
and relative humidity and then adjust zero flow level for the device.
3. Ask the patient to place the mouthpiece in his/her mouth, past his/her teeth and
ensure that the patient's lips are tightly sealed around the mouthpiece.
4. When the test starts, the patients should inhale and exhale normally at least 4 times,
then inhale and exhale completely filling and emptying their lungs, repeatedly,
uninterrupted, deeply, without breaking the seal of their lips for at least 12 seconds.
The patient may use a nose clip to help him/her to inhale and exhale only through
his/her mouth during this breathing maneuver.
5. Actively encourage the patient to breathe deeply and rapidly moving as much air as
possible for at least 12 seconds.
6. The patient may remove the mouthpiece from his/her mouth and resume normal
breathing once the breathing maneuver has been completed.
First Pub. Date: 24.09.2018
R.9-1 / 10.03.2020
