CPET Test Interpretation, Part 4: Interpretation and Summary
After having gone through the descriptive checklists for ventilatory, gas exchange and circulatory limitations the reason(s) for a patient’s exercise limitation, if any, should be reasonably clear. However, one of the first questions that should be asked when reading an exercise test is what was the purpose of the test? The interpretation and summary should … Read more
2019 ATS/ERS Spirometry Standards
The 2019 ATS/ERS Spirometry Standards were recently released. The standards are open-access and can be downloaded without charge from the October 15th issue of the American Journal of Respiratory and Critical Care Medicine. Supplements are available from the same web page. The 2019 Spirometry Standards have been extensively re-organized with numerous updates. Notably, a number … Read more
CPET Test Interpretation, Part 3: Circulation
I would like to re-emphasize the importance of the descriptive part of CPET interpretation. At the very least consider it to be a checklist that should always be reviewed even when you think you know what the final interpretation is going to be.
Welcome!
This website is a collection of articles to further your understanding in respiratory and sleep physiology and the world of lung function testing.
Calculating reference values?
The Global Lung Function Initiative (GLI) maintains the largest data repository that underpins the reference equations currently recommended by both the ATS and ERS. You can access the online calculator here.
CPET Interpretation Series
CPET Test Interpretation, Part 1: Ventilatory response
CPET Test Interpretation, Part 2: Gas Exchange
CPET Test Interpretation, Part 3: Circulation
CPET Test Interpretation, Part 4: Interpretation and Summary
CPET Test Interpretation, Part 2: Gas Exchange
I would like to re-iterate the importance of the descriptive part of CPET interpretation. At the very least consider it to be a checklist that should always be reviewed even when you think you know what the final interpretation is going to be.
CPET Test Interpretation, Part 1: Ventilatory response
I’ve always found interpreting CPET tests to be one of the more interesting (and enjoyable) things I’ve done. Interpreting a CPET test is both more difficult and easier than interpreting regular PFTs. More difficult because there are a lot more parameters involved and easier because determining test adequacy and the primary cause(s) of an exercise … Read more
Sharing opinions with Paul Enright
Dr. Paul Enright is a well-known name in the field of Pulmonary Function testing. He is the lead author or co-author of over a hundred articles and has served on many of the ATS/ERS standards committees. Introduction: We both retired in southern Arizona and live a couple of towns apart from each other. We have … Read more
Exercise Thresholds App
The Exercise Thresholds app is maintained by Felipe Mattioni and is a useful resource to learn, practice, and analyse the ventilatory thresholds in cardiopulmonary exercise tests. You can practice with sample data and upload your own data to interpret here.
2019 ATS/ERS Spirometry Standards
A modest proposal for a clinical spirometry grading system
A spirometry quality grading system. Or is it?
Sharing opinions with Paul Enright
N2 washout is affected by N2 excretion and other factors
The Lung Clearance Index (LCI) was first described in 1952 by Margaret Becklake, and is defined as the number of lung volume turnovers required to reduce the concentration of a tracer gas by a factor of 40. LCI is calculated as the cumulative exhaled volume (CEV) during the washout divided by the functional residual capacity … Read more
FEV1 and VC should be measured separately
The FEV1 and VC both provide quite different information about a patient’s lungs. Unfortunately, spirometry as it is currently practiced is optimized towards generating an accurate FEV1 more than an accurate VC. This is partly due to limitations in the maneuver itself and partly due to the lack of accurate end-of-test criteria for an adequate … Read more
Infection Control
The issue of infection control has been a topic of a couple of discussions I’ve had lately. In particular, it was reported to me that a PFT lab had come under fire from a Joint Commission inspector who did not believe that filter mouthpieces were adequate and that “patient valves and circuits need to be … Read more