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Lung Pulmonary Function Tests (LFT)

by | Feb 28, 2022 | Info | 0 comments

Pulmonary Function Tests (PFTs) Overview

Lung function tests (also called pulmonary function tests) include a variety of tests that check how well the lungs work. The most basic test is spirometry. This test measures the amount of air the lungs can hold. The test also measures how forcefully one can empty air from the lungs.

Spirometry is used to screen for diseases that affect lung volumes. It also is used to screen for diseases that affect the airways, such as chronic obstructive pulmonary disease (COPD) or asthma.

Uses of Pulmonary Function Tests (PFTs)

Doctors will order one or more PFTs, also known as lung function tests, to determine how well you’re able to breathe and how effectively your lungs send oxygen to the rest of your body.

If you already have a disease that’s affecting your lungs, your doctor may order this test to see if the condition is progressing or how it’s responding to treatment.

Pulmonary function tests (PFTs) can help diagnose the following conditions:

Pulmonary function tests (PFTs) can also help determine whether surgery is possible for lung cancer.


Types of Pulmonary Function Tests (PFTs)

There are several different types of pulmonary function tests (PFTs). Your doctor may perform one or more of these tests depending on what type of diseases they are investigating for.


Bronchial Provocation Test

A bronchial provocation test evaluates the sensitivity of your lungs. It’s often used to diagnose or rule out asthma as a cause of your symptoms.

The test can take one of three forms:

  • Exercise challenge. You exercise on a treadmill or stationary bicycle to see if physical exertion makes the airways react.
  • Irritant challenge: Your doctor exposes you to an asthma trigger, such as smoke or a chemical to see if your airways react.
  • Methacholine challenge: You inhale increasing doses of the chemical metacholine, which causes the airways to constrict with low doses among patients with asthma and with high doses in people without asthma. If there is no reaction at low doses, your doctor will look for another cause of your symptoms.


Cardiopulmonary Exercise Test (CPET)

A cardiopulmonary exercise test (CPET) is a specialized exercise stress test to gauge your ability to exercise and to diagnose what may be restricting your activity levels. It’s usually performed on a treadmill or stationary bicycle in a doctor’s office or PFT lab.

CPET evaluates how the following perform during physical exertion:

  • Blood vessels
  • Heart 
  • Lungs
  • Muscles

CPET also measures how much oxygen your body can use during exercise. Before the test, a nurse or technician will place monitors on your body including:

  • A blood pressure cuff
  • EKG leads to measure your heart rate
  • Mouthpiece attached with a tube to a flow meter to measure how deeply and quickly you breathe and how much oxygen and carbon dioxide flow in and out of your lungs
  • Pulse oximeter to measure oxygen saturation in the blood

The test itself lasts about 10 to 12 minutes. You begin by walking or pedaling slowly for a few minutes. After that, the treadmill will move faster or the resistance will increase on the stationary bicycle until you need to stop. Before stopping entirely, however, you will continue walking or pedaling at a slow rate to cool down.

Diffusion Capacity Test

This test evaluates how well the small air sacks inside the lungs, called alveoli, work. For this part of a pulmonary function test, you will be asked to breathe in carbon monoxide.

You may also breathe in a “tracer gas” for one breath. The machine can detect when you breathe out this gas. This tests how well your lungs are able to transfer oxygen and carbon dioxide to and from your bloodstream.


Exhaled Nitric Oxide Test

Like spirometry, an exhaled nitric oxide test requires you to breathe in deeply and then exhale fully into a mouthpiece attached to a monitor that measures the amount of nitric oxide in your breath.

An elevated level of nitric oxide in your breath suggests inflammation in your airways and possibly allergic asthma. The appropriate treatment is usually corticosteroids to reduce the inflammation.

Spirometry

Your PFTs may include spirometry, a painless test that can be performed at a doctor’s office, hospital, or a special lab where they have pulmonary function test (PFT) equipment available.

Spirometry is especially helpful in diagnosing asthma and COPD. This is because it tests how much air you can exhale from your lungs after taking in a big breath and how fast you can blow out all that air.

To conduct this test, the patient usually sits upright in front of a spirometry machine attached to a plastic mouthpiece. It’s important that the mouthpiece fits snugly so that all the air you breathe goes into the machine. You’ll also wear a nose clip to keep you from breathing air out through your nose.

The respiratory technologist will explain how to breathe for the test. They’ll ask you to take a deep breath in, then exhale as forcefully and as quickly as you can until you empty your lungs. You’ll then be allowed to breathe as usual before repeating the test two more times.

You may also be asked to breathe in a medication that opens your airways. You’ll then take another deep breath and exhale into the machine again to see if the medication improved your lung function.

Preparation of Pulmonary Function Tests (PFTs)

The purpose of pulmonary function tests (PFTs) are trying to assess the exact nature of your lung function, you may need to take certain steps prior to the test. For example, you may need to stop taking medications for asthma or chronic bronchitis that open your airways.

Your doctor should explain any changes to your medication routine ahead of time. You may have to avoid taking medications for pain, both prescription and over-the-counter drugs, because they may interfere with test results.

What to avoid on the day of your PFT

You should also avoid the following on the day of your test:

  • Eating a large meal
  • Consuming coffee, tea, chocolate, or other items containing caffeine
  • Smoking at least one hour before the test
  • Strenuous exercise

Other considerations before PFT

Be sure to wear loose clothing to the test, particularly if you will be walking on a treadmill or riding a stationary bike. Tighter clothing may restrict your breathing, even if you’re just sitting during the test.

Other considerations include:

  • Avoid wearing jewelry that might affect your breathing. 
  • Be prepared to rest after a test that requires exercise or multiple exhalations, as these can make you lightheaded or winded.
  • Wear dentures or other removable dental appliances to ensure your mouth will fit tightly around a mouthpiece used for the test.
  • The patient may need to postpone the PFT if they have recently had eye, chest, or abdominal surgery or a heart attack.

Results of the Pulmonary Function Tests (PFTs)

Some PFT results are available right away, especially if your doctor is present for the tests. In other cases, when a technician is administering the test, the results are then interpreted by a pulmonologist.

A pulmonologist is a doctor who specializes in lung health. They’ll review and interpret your tests and send the results to your doctor.

You may have to wait 48 to 72 hours to get those results and discuss them with your doctor.

 

Risk Factors of Pulmonary Function Tests (PFTs)

A pulmonary test (PFT) can cause problems if you’ve recently had any of the following:

PFTs are usually safe for most people. However, because the test may require you to breathe in and out quickly, you may feel dizzy or experience shortness of breath.

There’s also a risk that you may faint. If you feel lightheaded, tell your doctor. You may also want to arrange for someone to help you get home after the test.

If you have asthma, the test may cause you to have an asthma attack. In very rare cases, PFTs may cause a collapsed lung. If there are complications after the test, there will be medical professionals standing by to help.

Outcome of Pulmonary Function Tests (PFTs)

PFTs are typically performed if a patients is having symptoms such as shortness of breath, wheezing, or coughing. These tests can be useful in diagnosing or ruling out certain respiratory conditions, but they are only some of the tools doctors use in concluding an accurate diagnosis and planning a treatment plan.

Most PFTs are short, simple tests of your breathing ability, though some involve exercise. If your doctor orders a PFT, be sure to find out how to prepare for that particular test. You may, for example, be advised against exercising or consuming caffeine the day of a test.

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