Used to diagnose and assess assorted pulmonary conditions, spirometry is a simple, basic medical test with a wide array of uses in medicine. But exactly what is spirometry, and how is it performed? The basics can be explained and understood easily, even by people without medical training.
In essence, spirometry is a pulmonary function test that measures both the speed and volume of air inhaled and exhaled by the lungs. This simple but critical test is used to assess conditions ranging from cystic fibrosis to asthma, chronic obstructive pulmonary disease (COPD) to pulmonary fibrosis.
Spirometry tests are performed with devices called spirometers. While many variations of this device exist, for the most part, they generate two different graphical representations, or spirograms, of airflow. The first, which displays time along one axis and volume along the other, is called the volume-time curve. The second, which shows volume on one axis and speed, or airflow, along the other, is known as the flow-volume loop.
The procedure itself is a simple one. The patient is asked to inhale as deeply as possible, and then exhale directly into the device for as long as he can. For the most accurate readings, an exhalation of at least six seconds is preferred. Brief moments of rapid breathing or quiet breathing may precede or follow the test, depending on the particular device and the condition being assessed. Often, nose clips are utilized to prevent air from escaping through the nostrils, and disposable filters at the mouthpiece offer protection from the spread of germs and bacteria.
Spirometry has notable limitations, with perhaps the biggest being the cooperation necessary from the patient in order to acquire accurate readings. Even though tests are typically repeated at least three times, patients who fail to cooperate completely, or who do not fully understand the directions, can skew the results. Thus, medical professionals need to use caution to not mis-read the results. The test is ineffective on young children who are not yet able to follow directions accurately, generally children under five or six years old, and it is fully useless for patients who are incapacitated in some way, such as comatose or anesthetized patients. One final limitation exists regarding asthmatics in particular: In the midst of an attack, results will be indicative of that moment only, not as a general measure. To monitor a progressively worsening condition over time, individuals should test regularly when they are feeling well and suffering no notable problems, recording their scores and values over time.
Spirometry as a diagnostic tool has been used in various forms for hundreds of years, with one early recorded experiment dating to the second century A.D. Rapid advances in technology were made in the 1800s and early 1900s, before the ultimate development of an inexpensive, easy to use device that measured peak air flow in 1974, the predecessor to today’s many different spirometer technologies.
Spirometry has a valuable place in the diagnosis and ongoing assessment of pulmonary disorders, particularly those that worsen over time. However, the clear and obvious limitations of the technology mean we may never stop looking for new and improved ways to perform the same calculations, with ever more accuracy.
