Spirometry Indications and Contraindications

Spirometry is a type of pulmonary function test that is used to measure and evaluate the function of the lungs for a variety of purposes. It is indicated in a variety of situation but is not recommended for others, as outlined in more detail below.

Indications for Spirometry

Spirometry is commonly used to detect and diagnose pulmonary diseases, such as:

• Asthma
• Chronic obstructive respiratory disease (COPD)
• Cystic fibrosis
• Pulmonary fibrosis

Additionally, individuals with these conditions will regularly need follow-up tests to monitor lung function and the progression of the disease. It also provides a technique to evaluate the efficacy of the medications used in the treatment of these conditions and any changes over time.

Spirometry is also useful to determine the baseline lung function of an individual, providing a point of reference that to compare future results against and notice any changes that occur over time. This is particularly valuable for individuals that work in an environment with a high occupational risk for lung disease. This includes workplaces that are associated with increased exposure to irritants, such as dust and toxic particles in the air that may cause a decline in lung function.

Additionally, the tests can help in the investigation of certain respiratory symptoms, such as persistent cough or shortness of breath, also known as dyspnea. It may also be recommended for heavy smoker over the age of 35, due to the increased risk of pulmonary diseases.

Spirometry is routinely included in pre-surgical tests to evaluate the risk of pulmonary complications prior to undertaking some surgical procedures.

Contraindications for Spirometry

Spirometry is generally considered to be very safe and it rarely results in complications for patients. It can occasionally cause effects in some individuals, such as dizziness, faintness, shakiness, nausea and fatigue, but these are typically short-lived and resolve shortly after the test.

However, there are some instances when spirometry tests can do more harm than good and are contraindicated. In most cases, this is due to the effect of the increased pressure in certain areas of the body upon forced exhalation. In particular, this pressure affects the head, chest, stomach and eyes and some health conditions in these areas can respond poorly.

For example, recent surgery to the head, chest, stomach or eye regions may be affected by the pressure and heal incorrectly due to a spirometry test conducted shortly after the procedure. Additionally, unstable angina, uncontrolled hypertension or a recent myocardial infarction (heart attack) or stroke are also contraindications for spirometry tests.

Other contraindications for spirometry include coughing up blood (hemoptysis) without a known cause, active tuberculosis and a history of syncope associated with forced exhalation. Individuals with a history or increased risk of pneumothorax should also avoid spirometry testing.

Balancing Indications and Contraindication

Similarly to most decisions in healthcare, the final decision as to whether to use spirometry to gather information about the pulmonary function depends on the individual case. It is important for the healthcare professional to weigh up the potential risks and benefits for the individual to allow the most appropriate therapeutic decision to be made.

References

• http://emedicine.medscape.com/article/303239-overview
• http://www.nhs.uk/conditions/spirometry/Pages/Introduction.aspx
• http://patient.info/health/spirometry-leaflet
• https://www.nlm.nih.gov/medlineplus/ency/article/003853.htm

Further Reading

• All Spirometry Content
• What is Spirometry?
• Spirometry Results

Written by

Yolanda Smith

Yolanda graduated with a Bachelor of Pharmacy at the University of South Australia and has experience working in both Australia and Italy. She is passionate about how medicine, diet and lifestyle affect our health and enjoys helping people understand this. In her spare time she loves to explore the world and learn about new cultures and languages.