Strategies for the Management of a Pulmonary Function Laboratory

Pulmonary function tests (PFTs) are imperative to the diagnosis of people with respiratory symptoms and lung disease and to disease management. PFTs require expertise to obtain both high-quality tests and proficiency in test interpretation. In this review, we provide recommendations for obtaining high-quality test results in an efficient and cost-effective manner guided by available evidence and expert opinion. The medical director plays a critical role in pulmonary laboratory operations and ultimately is responsible for laboratory performance. Responsibilities of the medical director are reviewed and discussed. Quality control is an underappreciated part of the pulmonary laboratory that is that is necessary high-quality tests. What constitutes a complete PFT and the order that tests are performed may differ among laboratories. We suggest an approach to the performance of spirometry, bronchodilator-responsiveness testing, diffusing capacity, lung volumes, and tests of respiratory muscle strength that maximizes clinical usefulness and laboratory efficiency. Appropriate resources, time, and expertise are needed to run an efficient pulmonary function laboratory capable of performing high-quality testing.