Spirometry: an essential clinical measurement

Respiratory disease is common and amenable to early detection and management in the primary care setting. Spirometric evaluation of ventilatory function plays a critical role in the diagnosis, differentiation and management of respiratory illness such as asthma, chronic obstructive pulmonary disease and restrictive lung disorders, and is important in the assessment of lung health in smokers and those exposed to occupational and environmental hazards.

This article covers the basic theory, fundamentals of test indications, performance and equipment, the interpretation of results and the nuances behind the spirogram and the flow-volume curve.

The use of spirometry by primary care physicians, practice nurses and physiotherapists is now practicable and supported by a comprehensive range of devices, training courses and reference materials. Systematic use of ventilatory assessment both in the clinic and with patient self monitoring of peak flow and FEV1 has the capacity to improve patient understanding, confidence in self management, and quality of life for those with lung disease. Spirometry may also provide a useful modality for following the progress of those with neuromuscular disease and incipient respiratory muscle weakness and for the promotion of respiratory health in the community setting, although further research in all these areas is required.