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Lung function tests check how well your lungs work. The tests can find lung problems, measure how serious they are, and check to see how well treatment for a lung
disease is working.
The tests look at:
Types of lung function tests include:
You may also hear the tests called pulmonary function tests, or PFTs.
Lung function results are measured directly in some
tests and are calculated in others.
No single test can determine all of the
lung function values, so more than one type of test may be done. Some of the
tests may be repeated after you inhale medicine that enlarges your airways
Spirometry is the most common lung function
test. It measures how much and how quickly you can move air out of your lungs.
You breathe into a mouthpiece attached to a machine called a spirometer. The machine records your results.
Spirometry can measure many different things about the way you breathe. These include how much air you can exhale, how much air you can breathe in and out in 1 minute, and the amount of air left in your lungs after a normal exhale.
Gas diffusion tests measure
the amount of
oxygen and other gases that move through the lungs' air sacs (alveoli) per minute.
These tests let you know how well gases are being absorbed into your blood from
your lungs. Gas diffusion tests include:
Body plethysmography may be
used to measure:
Inhalation challenge tests are done to measure how your airways respond to substances that may be causing
asthma or wheezing. These tests are also called
the test, you inhale increasing amounts of a substance through a
nebulizer. This is a device that uses a face mask or a mouthpiece to deliver the
substance in a fine mist (aerosol). Spirometry
readings are taken to evaluate lung function before, during, and after you inhale
Exercise stress tests
look at how exercise affects your lungs. Spirometry readings are
done after exercise and then again at rest.
washout test is done to check people who have cystic fibrosis. For
this test, you breathe through a tube. First you breathe air that contains a tracer gas. Then you
breathe regular air while the amount of tracer gas you exhale is monitored.
Test results are reported as a lung clearance index (LCI). A high LCI value
means that the lungs are not working well.
Lung function tests are done to:
Tell your doctor if you:
Do not eat a heavy meal just before this test. A full stomach may keep your lungs from fully expanding. You should not smoke
or do intense exercise for 6 hours before the test.
For the test,
wear loose clothing that doesn't restrict your breathing in any way.
Avoid food or drinks with caffeine. Caffeine can cause your
airways to relax and allow more air than usual to pass through.
you have dentures, wear them during the test. They help you form a tight seal
around the mouthpiece of the machine.
Lung function tests are usually done in
special rooms that have all of the right equipment. The
test is usually done by a specially trained
respiratory therapist or technician.
For most of the
tests, you'll wear a nose clip to keep air from leaking through your nose. Then you'll breathe into
a mouthpiece connected to a recording device.
The exact steps depend on which test you have.
For example, you may be asked to inhale as
deeply as possible and then to exhale as fast and as hard as possible. You also
may be asked to breathe in and out as deeply and rapidly as you can for 15
Some tests may be repeated after you have inhaled a spray containing
medicine that expands the airways in your lungs. You may be
asked to breathe a special mixture of gases, such as 100% oxygen, a mixture of
helium and air, or a mixture of carbon monoxide and air.
Sometimes a sample of
blood may be taken from an artery in your wrist to measure blood gases.
If you have body plethysmography, you will be asked to sit inside a small
enclosure. It's similar to a telephone booth, with windows that allow you to see out.
The booth measures small changes in pressure that occur as you breathe.
The accuracy of the tests depends on how well you can follow all of the
instructions. The therapist may ask you to breathe deeply during
some of the tests to get the best results.
The testing may take
from 5 to 30 minutes. It depends on how many tests are done.
If you have an arterial blood gas test,
you may feel some pain from the needle used to collect the blood. The other
lung function tests are usually painless. Some of the tests may be tiring for
people who have a lung disease.
You may cough or feel lightheaded
after breathing in or out rapidly, but you will be given a chance to rest
between tests. It may not be comfortable to wear the nose clip or to breathe through the mouthpiece.
If you have body plethysmography, you may feel uncomfortable in the
airtight booth. But the therapist will be nearby to open the door if you feel too uncomfortable.
If you are given
breathing medicine, it may cause you to shake or may increase your heart rate.
If you feel any chest pain or discomfort, tell the therapist right away.
For a healthy person, there's little or no risk in taking these tests. If you have a serious heart or lung condition, discuss your
risks with your doctor.
Most test results are available right away.
Results are in the normal range for a person with healthy lungs.
Test results are outside of the normal range for a person with healthy lungs. This may be a sign of some kind of lung disease. There are two main types of lung disease that can be found with lung function tests: obstructive and restrictive.
Obstructive lung conditions cause the airways to get narrower.
Examples include emphysema,
bronchitis, asthma, and infection that produces inflammation.
Forced vital capacity (FVC)
How much air you can exhale with force after you inhale as deeply as possible.
Normal or lower than predicted value
Forced expiratory volume (FEV1)
How much air you can exhale with force in one breath.
FEV1 divided by FVC
See the first two tests above.
Forced expiratory flow 25% to 75%
How much air you can breathe out halfway through an exhale.
Peak expiratory flow (PEF)
How much air you can exhale when you try your hardest.
Maximum voluntary ventilation (MVV)
The greatest amount of air you can breathe in and out during 1 minute.
Slow vital capacity (SVC)
How much air you can slowly exhale after you inhale as deeply as possible.
Normal or lower
Total lung capacity (TLC)
The amount of air in your lungs after you inhale as deeply as possible.
Normal or higher
Functional residual capacity (FRC)
The amount of air in your lungs at the end of a normal exhaled breath.
Residual volume (RV)
The amount of air in your lungs after you have exhaled completely.
Expiratory reserve volume (ERV)
The difference between the amount of air in your lungs after a normal exhale (FRC) and the amount after you exhale with force (RV).
RV divided by TLC ratio
See the test above.
Restrictive lung conditions cause a loss of lung tissue, a decrease in the lungs' ability to expand, or
a decrease in how well the lungs can transfer oxygen or carbon
dioxide in or out of the blood.
Examples include scleroderma,
and sarcoidosis. Other restrictive conditions
include some chest injuries, being very overweight (obesity),
pregnancy, and loss of lung tissue due to surgery.
Lower than predicted value
Normal, lower, or higher
You may not be able to
have the test, or the results may not be helpful, if:
Other Works Consulted
Chernecky CC, Berger BJ (2013). Laboratory Tests and Diagnostic Procedures, 6th ed. St. Louis: Saunders.
Fischbach FT, Dunning MB III, eds. (2009).
Manual of Laboratory and Diagnostic Tests, 8th ed.
Philadelphia: Lippincott Williams and Wilkins.
Gustafsson PM, et al. (2008). Multiple-breath inert
gas washout and spirometry versus structural lung disease in cystic fibrosis.
Thorax, 63(2): 129–134.
Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby.
ByHealthwise StaffPrimary Medical ReviewerE. Gregory Thompson, MD - Internal MedicineSpecialist Medical ReviewerMark A. Rasmus, MD - Pulmonology, Critical Care Medicine, Sleep Medicine
Current as ofFebruary 4, 2015
Current as of:
February 4, 2015
E. Gregory Thompson, MD - Internal Medicine & Mark A. Rasmus, MD - Pulmonology, Critical Care Medicine, Sleep Medicine
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