Internet Resources for Pulmonary Patients:
A tri-fold brochure for patients.
Adult PFT Reference Equations:
Spreadsheets containing the adult reference equations for spirometry, lung volumes, DLCO and 6-minute walk with source bibliographies.
Adult Reference Equation Explorer – MS Excel Version
Adult Reference Equation Explorer – LibreOffice Version
LOINC PFT Codes:
The LOINC coding system is used to identify medical information transmitted between different medical institutions. The following spreadsheets contain the LOINC codes for pulmonary function tests.
John B. West Respiratory Physiology Lectures on YouTube
Based on his lectures and his classic textbook, Respiratory Physiology.
- Structure and Function
- Ventilation
- Blood Gas Transport
- Acid-Base Balance
- Diffusion
- Pulmonary Blood Flow
- Pulmonary Gas Exchange, Part 1
- Pulmonary Gas Exchange, Part 2
- Mechanics of Breathing, Part 1
- Mechanics of Breathing, Part 2
- Control of Ventilation
- Defense Systems of the Lung
- Respiration under Stress
- Respiration at the Limit
Websites:
AARC Office Spirometry Certificate Program
The Office Spirometry Certificate program is intended to provide a way for people outside the traditional pulmonary function lab setting to demonstrate understanding and receive quality feedback on performance. $$$.
Australia and New Zealand Society of Respiratory Science
Two sets of standardized waveforms that are used to test spirometry software. The first set (24 files) was created by John Hankinson at NIOSH in Morgantown, WV. The data is in liters at 10 msec intervals (i.e. 100 hz) and the second set (26 files) contain flows (L/sec), at 0.002 second (500 hz) sampling intervals. Since the files consist solely of volume data points, flow is synthesized by calculating the difference between adjacent volumes and dividing by the difference in time.
ATS/ERS Pulmonary Function Testing Guidelines
The ATS/ERS standards for spirometry, lung volumes, diffusing capacity, 6-minute walks, and PFT interpretation.
COAL WORKERS’ HEALTH SURVEILLANCE PROGRAM (CWHSP)
A NIOSH program for training and certification of spirometry clinics for regular testing of coal workers.
Resource for the GLI spirometry reference equations. Downloadable software, spreadsheet and articles.
NIOSH Spirometry
Links to NIOSH spirometry training programs, training guide, and publications.
NIOSH Spirometry Longitudinal Data Analysis (SPIROLA) Software
SPIROLA software is an easy-to-use visual and quantitative tool intended to assist health care providers in monitoring and interpreting computerized longitudinal spirometry data for individuals as well as for a group. Primary audience is Occupational testing. No $$$.
Searchable database of biomedical journal articles with links. Maintained by the NIH.
British online community for healthcare professionals with an interest in respiratory care .
Spirometry. Interpreting the flow-volume loop.
A website with an introduction to spirometry and the flow-volume loop. In English, French and Dutch.
On-line training in spirometry concepts, testing issues, problems, and statistics. Content managed by Philip Quanjer, MD. In English, Dutch, French and Spanish.
Open Access Pulmonary Journals:
These journals are either completely open access or journals where articles are available a year or two after the publication date.
Clinical Medical Insights: Circulatory, Respiratory and Pulmonary Medicine
European Clinical Respiratory Journal
European Respiratory Journal (18 month delay, all issues back to 1988)
International Journal of Chronic Obstructive Pulmonary Disease
Journal of Applied Physiology (1 year delay, all issues back to 1996)
Journal of Pulmonary & Respiratory Medicine
Multidisciplinary Respiratory Medicine
Respiratory Care (1 year delay, all issues back to 2003)
Respiratory Medicine Journal (2 year delay, all issues back to 2010)
Thorax (3 year delay, all issues back to 1946)
PFT Blog by Richard Johnston is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Richard,
As expected you’ve done a wonderful review of the new 2017 DLCO technical standards. I’ve been a fan of your Blog website for many years and wanted to know the entire pulmonary diagnostic community benefits from your dedication to the profession. Thank you for all you do and keep up the outstanding work
Can any share with me a QA Template? email: dwhitfield@mhemail.org
Hello! Please share the normal CPET values. Andr2889@bk.ru
Andrey –
CPET results are very interdependent and trying to understand them based solely on normal values doesn’t work all that well. To understand CPET results you need to understand the underlying physiology and the best place to start is with the various organizational statements such as:
ATS/ACCP statment on cardiopulmonary exercise testing. Amer J Respir Crit Care Med 2003; 167(1): 211-277.
Clinicians guide to cardiopulmonary exercise testing in adults: A scientific statement from the American Heart Association. Circulation 2010; 122(2): 191-225.
EACPR/AHA scientific statement. Clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations. Eur Heart J 2012; 33: 2917-2927.
I’d also recommend:
Clinical exercise testing. Eur Resp Soc Monograph June 2007; 12: Monograph 40.
Wasserman et al. Principles of exercise testing and interpretation. Published by Lipincott, Williams and Wilkins.
All or most of the statements are open access and can be downloaded from the various journal websites. The ERS monograph can also be found on-line. Various editions of Wasserman’s textbook can be ordered from a number of used book store websites.
Regards, Richard
Richard, I have a question concerning. PFT labs and negative pressure Room.
Is there anywhere stating that a PFT lab needs to be in a Negative Pressure Room.
Thank you in advance.
Domenic
Domenic –
The ATS Pulmonary Function Laboratory Management & Procedure Manual, Third Edition, when discussing PFT testing on patients with cystic fibrosis (chapter 4, page 37), indicates that a negative pressure room is one option for controlling cross-infection, however other alternatives for CF patients are to test in rooms equipped with HEPA filters or just waiting 30 minutes between patients. For patients with tuberculosis the manual strongly suggests that testing be performed in the patient’s isolation room and these rooms are often equipped with negative pressure ventilation (although I’d have serious concerns about equipment contamination in a Tb patient’s room and my lab’s policy is to never test anybody with known or suspected Tb).
Other than that there is no specific requirement that all PFTs be performed in a negative pressure room. It’s an interesting point since PFT testing often triggers coughing so at first glance it could be argued that this would be desirable precaution. Most of the time however, coughing occurs in patients with non-communicable disorders such as pulmonary fibrosis and asthma, so the risk to staff and other patients is likely to be very small.
The primary point of a negative pressure room is to prevent patient cross-infection and so I suppose that there would be a potential benefit for any patient that is immuno-compromised. I think a far greater and more immediate concern however, for any patient should be the more direct transmission routes involving surface contamination of the equipment and physical contact by staff and these routes are going to be present regardless of whether or not testing is performed in a negative pressure room.
Regards, Richard
Thank you Richard…
God Bless you Richard. Sorry to hear about your illness.
I have enjoyed your blog. Being in medical diagnostic sales for the past 36+ years it has helped me understand things.
Regards,
William Clark DeLashmutt
Thank you Richard!!!
I hope you’re feeling well.
Can you tell me why a PFT lab would require a hgb draw before a Methacholine challenge test?
Diana –
I can’t see any reason why you’d want a hemoglobin before a methacholine challenge.
Regards, Richard
Thanks for the great blog and keep it coming while you can…