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AT-2plus User Guide Spirometry Supplement Page 51
Art. No. 2. 510339wa ©1999
AT-2plus User Guide Spirometry Supplement Page 51
Art. No. 2. 510339wa ©1999
Spirometry Tips - How To Do It and Common Pitfalls and Problems
Remember, particularly in patients with airflow obstruction, that it may take many seconds to fully exhale. It is also
important to recognise those patients whose efforts are reduced by chest pain or abdominal problems, or by fear of
incontinence, or even just by lack of confidence. There is no substitute for careful explanation and demonstration -
demonstrating the manoeuvre to the patient will overcome 90% of problems encountered and is critical in achieving
satisfactory results. Observation and encouragement of the patient’s performance are also crucial. Be sure to examine
the spirogram for acceptability and reproducibility, and to correct the measurements to BTPS (see Calibration).
Attention to fine detail in the performance of the breathing manoeuvre is critical to obtaining reliable results.
At least three technically acceptable manoeuvres should be obtained, ideally with less than 0.2 L variability for FEV1
(and FVC) between the highest and second highest result. Quote the largest value. The American Thoracic Society
(ATS) provides the following guidelines for manoeuvre performance.
FVC
° Minimum of 3 acceptable blows
° A rapid start is essential: this is defined as a back-extrapolated volume of <5% of FVC or 0.15 L, whichever is
greater.
° At least 6 second expiration
° End of test - no change in volume for at least 1 second after exhalation time of 6 seconds; or FET >15 seconds;
or stopped for clinical reasons
° Spirometer temperature between 17 and 40 degrees Celsius; measure spirometer temperature to one degree
Celsius
° Use of nose clip is encouraged
° Sitting or standing
° Reproducibility: the highest and second highest FVC should agree to within 0.2L
Spirometry Tips - How To Do It and Common Pitfalls and Problems
Remember, particularly in patients with airflow obstruction, that it may take many seconds to fully exhale. It is also
important to recognise those patients whose efforts are reduced by chest pain or abdominal problems, or by fear of
incontinence, or even just by lack of confidence. There is no substitute for careful explanation and demonstration -
demonstrating the manoeuvre to the patient will overcome 90% of problems encountered and is critical in achieving
satisfactory results. Observation and encouragement of the patient’s performance are also crucial. Be sure to examine
the spirogram for acceptability and reproducibility, and to correct the measurements to BTPS (see Calibration).
Attention to fine detail in the performance of the breathing manoeuvre is critical to obtaining reliable results.
At least three technically acceptable manoeuvres should be obtained, ideally with less than 0.2 L variability for FEV1
(and FVC) between the highest and second highest result. Quote the largest value. The American Thoracic Society
(ATS) provides the following guidelines for manoeuvre performance.
FVC
° Minimum of 3 acceptable blows
° A rapid start is essential: this is defined as a back-extrapolated volume of <5% of FVC or 0.15 L, whichever is
greater.
° At least 6 second expiration
° End of test - no change in volume for at least 1 second after exhalation time of 6 seconds; or FET >15 seconds;
or stopped for clinical reasons
° Spirometer temperature between 17 and 40 degrees Celsius; measure spirometer temperature to one degree
Celsius
° Use of nose clip is encouraged
° Sitting or standing
° Reproducibility: the highest and second highest FVC should agree to within 0.2L