Forced Expiratory Volume (FEV1) Overview
FEV1 helps measure the progression of lung conditions such as chronic obstructive pulmonary disease (COPD) or asthma. FEV stands for forced expiratory volume, which is the air you exhale in 1 second. A low FEV1 suggests a breathing obstruction.
Working out a person’s FEV1 value can help diagnose chronic lung diseases, such as chronic obstructive pulmonary disease (COPD). FEV1 and other measurements also allow doctors to understand how severe the condition is and to track its progression over time.
Moreover, having trouble breathing is a hallmark symptom of COPD. Chronic obstructive pulmonary disease (COPD) causes air to get trapped in your airways, making it difficult for your lungs to exhale it all out. Asthma causes your airways to narrow, making it more difficult to breathe.
FEV1 is measured during a spirometry test, also known as a pulmonary function test, which involves forcefully breathing out into a mouthpiece connected to a spirometer machine.
Normal Ranges of FEV1
Healthy values for FEV1 vary from person to person. They’re based on standards for an average person of that age, race, height, and gender. However, each person has a predicted FEV1 value.
Although, you can get a general idea of your predicted value with a spirometry calculator. Accordingly, the Centers for Disease Control and Prevention (CDC) provides a calculator that lets you enter your details.
If you have already received a COPD or asthma diagnosis, your FEV1 score can help determine your condition’s stage. Moreover this is done by comparing your FEV1 score to the predicted value of those individuals similar to you without a lung condition.
FVC and FEV1
Rather, the FEV1 reading is just one measurement taken from a pulmonary function test. Forced vital capacity (FVC) is another important reading.
FVC shows the amount of air that a person can breathe out quickly and forcefully after a deep breath. The FEV1 measurement is recorded during the first second of the FVC test.
As with FEV1 readings, the FVC results are compared with average values from healthy individuals of the same age, height, and weight as the person undergoing testing.Furthermore, lower FVC readings can indicate more advanced stages of COPD.
Although, the ratio of FVC and FEV1 can help doctors diagnose the specific type of lung disease a person has. However, to calculate this ratio, a doctor divides the FVC reading by the FEV1 result.
Also, when the value of FEV1 is less than 70% of an FVC in adults or below 85% in those aged 5–18 years, an obstruction may be present. It may be a sign of COPD.
FEV1 Staging for COPD and Asthma
Your healthcare provider will calculate a percentage difference to compare your FEV1 score and predicted value. This percentage can help stage COPD.
According to the COPD GOLD guidelines from 2018:
GOLD stage of COPD | Percentage of predicted FEV1 value |
---|---|
Mild | 80% |
Moderate | 50%–79% |
Severe | 30%–49% |
Very severe | less than 30% |
For asthma, there are similar guidelines from the National Heart Blood and Lung Institute. They are:
Asthma stage | Percentage of predicted FEV1 value |
---|---|
Mild | >80% |
Moderate | 60%–79% |
Severe | <60% |
FEV1 and COPD Diagnosis
FEV1 is used in association with other tests to help diagnose COPD.
A COPD diagnosis may involve:
- A FEV1 reading
- An FVC reading
- A FEV1/FVC ratio
- An assessment of symptoms
- Medical and family histories
- Imaging tests, such as X-rays or CT scan
- An arterial blood gas test, to test blood oxygen levels
Many doctors also use a COPD assessment test (CAT) to find out how COPD affects a person’s life. Doctors will use the result of the CAT alongside other test results to determine the stage and severity of COPD.
FEV1 and COPD Management
COPD is a progressive condition, meaning that it worsens over time. Follow-up pulmonary function tests are carried out in people with COPD to track how the condition progresses, which varies from person to person.
Hence, the results of these tests will help the individual and the doctor understand how COPD is progressing over time.
Doctors also use these results when deciding on any treatment plan changes and when making recommendations about a person’s lifestyle.
Individuals who smoke may require more testing, as their symptoms are more likely to progress when compared with people who do not smoke.
What steps can someone with COPD take?
People with COPD should regularly attend medical appointments and complete recommended pulmonary function test (PFT). Also, knowing their FEV1 and FVC readings will help them understand the severity of their condition.
These results help guide the treatment plan, which the person should follow carefully.
There are other steps an individual with COPD can take to relieve symptoms and slow disease progression. These include:
- Avoiding exposure to common irritants, such as air pollution, chemical vapors, and dust
- Eating a balanced diet
- Engaging in regular physical activity
- Participating in a pulmonary rehabilitation program
- Using oxygen therapy as prescribed
- Quitting smoking
It is also vital to inform a doctor if a person notices any changes in symptoms. Symptoms of COPD flare-ups include worsening:
- Breathing difficulties
- Chest tightness
- Coughing and mucus production
- Difficulty exercising or engaging in everyday activities
- Shortness of breath
- Wheezing
Summary
Although, FEV1 is a useful measurement that is taken during a pulmonary function test. Therefore, the FEV1 value can be used alongside other tests to diagnose COPD and other lung conditions.
Also, FEV1 helps in the staging and management of a person’s condition and allows doctors to monitor COPD progression over time. As an individual’s lung capacity changes, so do their FEV1 measurements.
However, most people with COPD will need to undergo follow-up pulmonary function tests to check their FEV1. People who smoke may require more frequent testing.
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