[논문]Spirometry and Bronchodilator Test

Sim, Yun Su; Lee, Ji-Hyun; Lee, Won-Yeon; Suh, Dong In; Oh, Yeon-Mok; Yoon, Jong-seo; Lee, Jin Hwa; Cho, Jae Hwa; Kwon, Cheol Seok; Chang, Jung Hyun

doi:10.4046/trd.2017.80.2.105

Spirometry and Bronchodilator Test 원문보기

Tuberculosis and respiratory diseases : TRD = 결핵 및 호흡기 질환, v.80 no.2, 2017년, pp.105 - 112

Sim, Yun Su (Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital) , Lee, Ji-Hyun (Department of Allergy, Pulmonary and Critical Care Medicine, CHA Bundang Medical Center, CHA University) , Lee, Won-Yeon (Department of Internal Medicine, Yonsei University Wonju College of Medicine) , Suh, Dong In (Department of Pediatrics, Seoul National University Children's Hospital) , Oh, Yeon-Mok (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) , Yoon, Jong-seo (Department of Pediatrics, College of Medicine, The Catholic University of Korea) , Lee, Jin Hwa (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Womans University School of Medicine) , Cho, Jae Hwa (Division of Pulmonology and Critical Care, Department of Internal Medicine, Inha University School of Medicine) , Kwon, Cheol Seok (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) , Chang, Jung Hyun (Division of Pulmonary and Critical Care Medicin)

Abstract ▼ AI-Helper

Spirometry is a physiological test for assessing the functional aspect of the lungs using an objective indicator to measure the maximum amount of air that a patient can inhale and exhale. Acceptable spirometry testing needs to be conducted three times by an acceptable and reproducible method for determining forced vital capacity (FVC). Until the results of three tests meet the criteria of reproducibility, the test should be repeated up to eight times. Interpretation of spirometry should be clear, concise, and informative. Additionally, spirometry should guarantee optimal quality prior to the interpreting spirometry results. Our guideline adopts a fixed normal predictive value instead of the lower limit of normal as the reference value because fixed value is more convenient and also accepts FVC instead of vital capacity (VC) because measurement of VC using a spirometer is impossible. The bronchodilator test is a method for measuring the changes in lung capacity after inhaling a short-acting ${\beta}-agonist$ that dilates the airway. When an obstructive ventilatory defect is observed, this test helps to diagnose and evaluate asthma and chronic obstructive pulmonary disease by measuring reversibility with the use of an inhaled bronchodilator. A positive response to a bronchodilator is generally defined as an increase of ${\geq}12%$ and ${\geq}200mL$ as an absolute value compared with a baseline in either forced expiratory volume at 1 second or FVC.

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가설 설정

Reproducibility of the PFT is determined by comparing the values of FVC and forced expiratory volume at 1 second (FEV1) between tests, and should meet the following criteria. (1) The difference between the highest values of two FVCs should be within 5% or 150 mL. (2) When FVC is less than 1.

제안 방법

The bronchodilator test is a method for measuring the changes in lung capacity after inhaling a short-acting bronchodilator drug that dilates the airway. When an obstructive ventilatory defect is observed, this test helps to diagnose and evaluate asthma and COPD by measuring reversibility induced by the bronchodilator drug¹⁹.

이론/모형

Normal values of spirometry may differ depending on the physical requirements of the subjects, such as the race, sex, age, height and weight, measurement conditions, statistical methods, and socioeconomic or epidemiological requirements. Korea uses the Morris Asian Quanjer equation, described by Morris et al. in 1971⁹, or normal predictive values of spirometry in the Korean population, which were based on 2001 National Health and Nutrition Examination Survey¹⁰.
. This report is written based on the guideline for pulmonary function test (PFT), recently released by The Korean Academy of Tuberculosis and Respiratory Diseases, which can be used on a clinical field².

성능/효과

(1) Generally, a positive response is defined as an increase of ≥12% and ≥200 mL as an absolute value compared with baseline in either FEV₁ or FVC. (2) When expressing a bronchodilator response with a percentage of the pre-inhalation indicator, it tends to be calculated as larger when the baseline value of VC is smaller, even if the amount of variation is the same. (3) When the bronchodilator response is positive, it suggests asthma in general.
(2) FEV₁ is defined as expiratory volume that has been exhaled at the end of the first second of a maximally forced expiration maneuver. (3) FEV₁/FVC (FEV₁ ratio) is defined as the ratio of FEV₁ and FVC and is also expressed as a percentage. (4) Forced expiratory flow during the middle half of FVC(25%–75%) is defined as the average forced expiratory flow of 50% during the middle half of the test, except for the measurement of 25% at the beginning of the test and at the end of FVC.
(4) Forced expiratory flow during the middle half of FVC(25%–75%) is defined as the average forced expiratory flow of 50% during the middle half of the test, except for the measurement of 25% at the beginning of the test and at the end of FVC.

참고문헌 (21)

1 The BTS COPD Consortium Spirometry in practice. A practical guide to using spirometry in primary care 2nd ed London The BTS COPD Consortium 2005
2 The Korean Academy of Tuberculosis and Respiratory Diseases 2016 Guideline of pulmonary function test [Internet] Seoul The Korean Academy of Tuberculosis and Respiratory Diseases 2016 cited 2016 Nov 1 Available from: http://www.lungkorea.org/bbs/index.html?code=guide&category=&gubun=&page=1&number=3487&mode=view&keyfield=&key=
3 Gold WM Koth LL Chapter 25. Pulmonary function testing Broaddus VC Mason RJ Ernst JD King TE Lazarus SC Murray JF Murray and Nadel's textbook of respiratory medicine 6th ed Philadelphia Saunders/Elsevier 2015 407 435.e18
4 Miller MR Crapo R Hankinson J Brusasco V Burgos F Casaburi R General considerations for lung function testing Eur Respir J 2005 26 153 161 15994402

상세보기
5 Miller MR Hankinson J Brusasco V Burgos F Casaburi R Coates A Standardisation of spirometry Eur Respir J 2005 26 319 338 16055882

상세보기
6 Moore VC Spirometry: step by step Breathe 2012 8 232 240
7 Centers for Disease Control and Prevention The Fifth Korea National Health and Nutrition Examination Survey (2010-2012) Manual [Internet] Cheongju Centers for Disease Control and Prevention 2012 cited 2016 Nov 1 Available from: http://cdc.go.kr/CDC/contents/CdcKrContentView.jsp?cid=60948&menuIds=HOME001-MNU1130-MNU1639-MNU1749-MNU1760
8 Centers for Disease Control and Prevention National Health and Nutrition Examination Survey (NHANES): respiratory health spirometry procedures manual [Internet] Atlanta Centers for Disease Control and Prevention 2011 cited 2016 Nov 1 Available from: http://www.cdc.gov/nchs/data/nhanes/nhanes_11_12/Spirometry_Procedures_Manual.pdf
9 Morris JF Koski A Johnson LC Spirometric standards for healthy nonsmoking adults Am Rev Respir Dis 1971 103 57 67 5540840

상세보기
10 Choi JK Paek D Lee JO Normal predictive values of spirometry in Korean population Tuberc Respir Dis 2005 58 230 242
11 Rabe KF Hurd S Anzueto A Barnes PJ Buist SA Calverley P Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary Am J Respir Crit Care Med 2007 176 532 555 17507545

상세보기
12 Swanney MP Ruppel G Enright PL Pedersen OF Crapo RO Miller MR Using the lower limit of normal for the FEV1/FVC ratio reduces the misclassification of airway obstruction Thorax 2008 63 1046 1051 18786983

상세보기
13 Cerveri I Corsico AG Accordini S Niniano R Ansaldo E Anto JM Underestimation of airflow obstruction among young adults using FEV1/FVC <70% as a fixed cut-off: a longitudinal evaluation of clinical and functional outcomes Thorax 2008 63 1040 1045 18492741

상세보기
14 Pellegrino R Viegi G Brusasco V Crapo RO Burgos F Casaburi R Interpretative strategies for lung function tests Eur Respir J 2005 26 948 968 16264058

상세보기
15 National Institute for Health and Care Excellence Chronic obstructive pulmonary disease: management of chronic obstructive pulmonary disease in adults in primary and secondary care [Internet] London National Institute for Health and Care Excellence 2004 cited 2016 Nov 1 Available from: http://www.nice.org.uk/guidance/cg12
16 Peces-Barba G Barbera JA Agusti A Casanova C Casas A Izquierdo JL Diagnosis and management of chronic obstructive pulmonary disease: joint guidelines of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Latin American Thoracic Society (ALAT) Arch Bronconeumol 2008 44 271 281 18448019
17 American Thoracic Society Lung function testing: selection of reference values and interpretative strategies Am Rev Respir Dis 1991 144 1202 1218 1952453
18 Ministry of Health and Welfare The criteria for decision of pulmonary disability-grading: notification No. 2015-188 [Internet] Sejong Ministry of Health and Welfare 2015 cited 2016 Nov 1 Available from: http://www.mohw.go.kr/front_new/jb/sjb0406ls.jsp?PAR_MENU_ID=03&MENU_ID=030406&page=30
19 National Center for Health Statistics Centers for Disease Control and Prevention National Health and Nutrition Examination Survey (NHANES): respiratory health bronchodilator procedure manual [Internet] Atlanta Centers for Disease Control and Prevention 2008 cited 2016 Nov 1 Available from: http://www.cdc.gov/nchs/data/nhanes/nhanes_07_08/Bronchodilator.pdf
20 van Schalkwyk EM Schultz C Joubert JR White NW South African Thoracic Society Standards of Spirometry Committee Guideline for office spirometry in adults, 2004 S Afr Med J 2004 94 7 Pt 2 576 587 15283308
21 Global Initiative for Asthma Diagnosis of diseases of chronic airflow limitation: 2015 asthma, COPD and asthma-COPD overlap syndrome (ACOS) [Internet] Global Initiative for Asthma 2015 cited 2016 Oct 12 Available from: http://ginasthma.org/asthma-copd-and-asthma-copd-overlap-syndrome-acos

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