How to interpret parameters of routine lung function tests in 2023?

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Published Aug 24, 2023
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Vol. 101 No. 3 (2023): Tunis Med mars 2023

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Fatma Guezguez
1Service de physiologie et explorations fonctionnelles. EPS Farhat HACHED. Sousse. Tunisie 2Laboratoire de physiologie. Faculté de Médecine de Sousse. Université de Sousse. Sousse. Tunisie 3Laboratoire de recherche “Insuffisance Cardiaque, LR12SP09”, EPS Farhat HACHED, Sousse, Tunisie
Inès Ghannouchi
1Service de physiologie et explorations fonctionnelles. EPS Farhat HACHED. Sousse. Tunisie 2Laboratoire de physiologie. Faculté de Médecine de Sousse. Université de Sousse. Sousse. Tunisie 3Laboratoire de recherche “Insuffisance Cardiaque, LR12SP09”, EPS Farhat HACHED, Sousse, Tunisie
Amani Sayhi
1Service de physiologie et explorations fonctionnelles. EPS Farhat HACHED. Sousse. Tunisie 2Laboratoire de physiologie. Faculté de Médecine de Sousse. Université de Sousse. Sousse. Tunisie 3Laboratoire de recherche “Insuffisance Cardiaque, LR12SP09”, EPS Farhat HACHED, Sousse, Tunisie
Emna Charfedi
1Service de physiologie et explorations fonctionnelles. EPS Farhat HACHED. Sousse. Tunisie
Arwa Yahyaoui
1Service de physiologie et explorations fonctionnelles. EPS Farhat HACHED. Sousse. Tunisie
Sonia Rouatbi
1Service de physiologie et explorations fonctionnelles. EPS Farhat HACHED. Sousse. Tunisie 2Laboratoire de physiologie. Faculté de Médecine de Sousse. Université de Sousse. Sousse. Tunisie 3Laboratoire de recherche “Insuffisance Cardiaque, LR12SP09”, EPS Farhat HACHED, Sousse, Tunisie
Helmi Ben Saad
University of Sousse, Faculty of Medicine of Sousse
https://orcid.org/0000-0002-7477-2965

Abstract

The diagnosis and management of the most prevalent chronic respiratory diseases partially rely on parameters obtained from pulmonary functional tests (PFTs), including spirometry, plethysmography, and carbon monoxide diffusion capacity (DLCO) measurement. In practice, the interpretation of PFTs’ parameters is based on international recommendations issued by renowned scientific societies such as the American Thoracic Society (ATS) and the European Respiratory Society (ERS). The interpretation standards for PFTs established by ATS/ERS in 2005 were updated in 2022. According to the ATS/ERS-2022 standards, the interpretation of PFTs can be summarized in five steps. The first step involves comparing the determined parameters with those observed in a reference population of healthy individuals. This step helps determine whether the determined parameters are low, normal, or elevated. The second step aims to identify potential ventilatory impairments, such as obstructive and/or restrictive ventilatory impairments, which can be observed in certain chronic respiratory or extrarespiratory diseases. The third step involves assessing the severity of the identified ventilatory impairment or the decrease in DLCO. The fourth step entails evaluating the response to bronchodilator testing, if performed. Finally, if previous PFTs results are available, it is important to identify significant changes in certain PFTs parameters over time by comparing current and previous results. This clinical practice guide provides a comprehensive synthesis of the different steps in PFTs interpretation, taking into account the recommendations from ATS/ERS-2022.

Keywords:

Algorithm, Asthma, COPD, PFT, Interpretation, Scientific societies, FEV1Q, z-score

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Author Biographies

Fatma Guezguez, 1Service de physiologie et explorations fonctionnelles. EPS Farhat HACHED. Sousse. Tunisie 2Laboratoire de physiologie. Faculté de Médecine de Sousse. Université de Sousse. Sousse. Tunisie 3Laboratoire de recherche “Insuffisance Cardiaque, LR12SP09”, EPS Farhat HACHED, Sousse, Tunisie

1Service de physiologie et explorations fonctionnelles. EPS Farhat HACHED. Sousse. Tunisie

2Laboratoire de physiologie. Faculté de Médecine de Sousse. Université de Sousse. Sousse. Tunisie

3Laboratoire de recherche “Insuffisance Cardiaque, LR12SP09”, EPS Farhat HACHED, Sousse, Tunisie

Inès Ghannouchi, 1Service de physiologie et explorations fonctionnelles. EPS Farhat HACHED. Sousse. Tunisie 2Laboratoire de physiologie. Faculté de Médecine de Sousse. Université de Sousse. Sousse. Tunisie 3Laboratoire de recherche “Insuffisance Cardiaque, LR12SP09”, EPS Farhat HACHED, Sousse, Tunisie

1Service de physiologie et explorations fonctionnelles. EPS Farhat HACHED. Sousse. Tunisie

2Laboratoire de physiologie. Faculté de Médecine de Sousse. Université de Sousse. Sousse. Tunisie

3Laboratoire de recherche “Insuffisance Cardiaque, LR12SP09”, EPS Farhat HACHED, Sousse, Tunisie

Amani Sayhi, 1Service de physiologie et explorations fonctionnelles. EPS Farhat HACHED. Sousse. Tunisie 2Laboratoire de physiologie. Faculté de Médecine de Sousse. Université de Sousse. Sousse. Tunisie 3Laboratoire de recherche “Insuffisance Cardiaque, LR12SP09”, EPS Farhat HACHED, Sousse, Tunisie

1Service de physiologie et explorations fonctionnelles. EPS Farhat HACHED. Sousse. Tunisie

2Laboratoire de physiologie. Faculté de Médecine de Sousse. Université de Sousse. Sousse. Tunisie

3Laboratoire de recherche “Insuffisance Cardiaque, LR12SP09”, EPS Farhat HACHED, Sousse, Tunisie

Emna Charfedi, 1Service de physiologie et explorations fonctionnelles. EPS Farhat HACHED. Sousse. Tunisie

1Service de physiologie et explorations fonctionnelles. EPS Farhat HACHED. Sousse. Tunisie

Arwa Yahyaoui, 1Service de physiologie et explorations fonctionnelles. EPS Farhat HACHED. Sousse. Tunisie

1Service de physiologie et explorations fonctionnelles. EPS Farhat HACHED. Sousse. Tunisie

Sonia Rouatbi, 1Service de physiologie et explorations fonctionnelles. EPS Farhat HACHED. Sousse. Tunisie 2Laboratoire de physiologie. Faculté de Médecine de Sousse. Université de Sousse. Sousse. Tunisie 3Laboratoire de recherche “Insuffisance Cardiaque, LR12SP09”, EPS Farhat HACHED, Sousse, Tunisie

1Service de physiologie et explorations fonctionnelles. EPS Farhat HACHED. Sousse. Tunisie

2Laboratoire de physiologie. Faculté de Médecine de Sousse. Université de Sousse. Sousse. Tunisie

3Laboratoire de recherche “Insuffisance Cardiaque, LR12SP09”, EPS Farhat HACHED, Sousse, Tunisie

Helmi Ben Saad, University of Sousse, Faculty of Medicine of Sousse

  • Professor of Physiology and Functional Explorations at the Faculty of Medicine of Sousse - Tunisia, Department of Physiology and Functional Explorations at EPS Farhat HACHED - Sousse - Tunisia.
  • President of the College of Physiology and Functional Explorations (terms: 2014-2017; 2021-2023).
  • Master's degree in Biological and Medical Sciences from the University of Montpellier I, France.
  • World expert in spirometry (ranked 1st in Africa): https://expertscape.com/ex/spirometry/c/afr.
  • Diploma of Advanced Studies in "Human Movement Sciences" from the University of Montpellier I, France.
  • Interuniversity Diploma "Pathophysiology of Exercise and Functional Exercise Explorations" from the University of Montpellier 1, France.
  • International PhD in Sciences between the Universities of Montpellier I (France) and Monastir (Tunisia).
  • European Spirometry Driving License Part 1 (theory only) and the European Spirometry Training Program (Part 2: knowledge and competence in practice) and the European Spirometry train-the-trainer course.
  • Invited speaker at numerous international congresses on respiratory functional explorations.
  • Author of over 220 scientific articles in indexed and impact factor journals.
  • Potential reviewer for over 80 indexed and impact factor journals and potential external reviewer for the University of Cape Town (South Africa) and Mutah (Jordan).
  • Winner of the Sadok BESROUR Award for Excellence in Medical Research (2021).
  • Web:
  1. http://scholar.google.fr/citations?hl=fr&user=oeV_0OwAAAAJ&view_op=list_works&sortby=pubdatehttp://www.researchgate.net/profile/Helmi_Ben_Saad
  2. https://publons.com/author/602231/helmi-ben-saad#profile
  3. https://www.researchgate.net/profile/Helmi_Ben_Saad

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