Technology in respiratory medicine

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South African Journal for Continuing Medical Education

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University of Cape Town

Technological advances have allowed complex respiratory physiology measurements to be made outside of dedicated pulmonary function laboratories. Office spirometry is an essential component of the effective management of respiratory disease, particularly asthma and COPD. Spirometers for consulting room use need to conform to technical standards recommended by the American Thoracic Society. Regular calibration of all pulmonary function testing is mandatory. The most reliable results from pulmonary function tests are obtained when the operator is a qualified clinical technologist or has undergone appropriate training in the tests to be performed. Reliable spirometry results require maximum inspiratory and expiratory efforts and technically acceptable curves. At last 3 acceptable curves are necessary and at least 2 should have re producible values. Reference values that have been demonstrated to be applicable to the population under study should be used. The ECCS reference equations are generally appropriate for South African use although an allowance may need to be made for individuals of non-European ancestry. Complex pulmonary function and exercise tests should be reserved for dedicated respiratory physiology laboratories as specialised testing gases, more complex equipment and appropriately trained and qualified staff are essential.