Assessment of Pulmonary Function in COPD

Christopher B. Cooper

doi:10.1055/s-2005-869543

Seminars in Respiratory and Critical Care Medicine, Table of Contents

Semin Respir Crit Care Med 2005; 26(2): 246-252
DOI: 10.1055/s-2005-869543

Assessment of Pulmonary Function in COPD

Christopher B. Cooper¹ ^, ²

¹Departments of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
²Departments of Physiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California

Abstract

ABSTRACT

Pulmonary function testing is used in the diagnosis of chronic obstructive pulmonary disease (COPD) and the staging of COPD severity. The current diagnostic criterion for airflow obstruction is a ratio of forced expiratory volume in 1 second (FEV₁) to forced vital capacity (FVC) < 70%. However this absolute definition can lead to false-negative determinations in younger patients and false-positive determinations in the elderly. Nevertheless, screening spirometry is advocated and becomes feasible in the physician office setting with the availability of compact, relatively affordable apparatus that meets the appropriate technical specifications. Spirometry should be complemented by measurement of lung volumes using body plethysmography in those with evidence of airflow obstruction. Small airways disease can be detected by various techniques that measure airway and total respiratory system resistance. There is renewed interest in the forced oscillation technique and impulse oscillometry because of their noninvasiveness and potential ability to distinguish small from larger airway disease. Finally, pulmonary function testing has an important role in preoperative risk assessment; for example, in patients being considered for lung volume reduction surgery or resection of a lung nodule.

KEYWORDS

Pulmonary function testing - COPD - screening spirometry - body plethysmography - impulse oscillometry - preoperative assessment

Full Text

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Christopher B CooperM.D.

David Geffen School of Medicine at UCLA, 10833 Le Conte Ave.

37-131 CHS, Los Angeles, CA 90095-1690

Email: ccooper@mednet.ucla.edu