The month of November is now being internationally-recognized as COPD Awareness Month. As efforts around the world will be directed towards COPD awareness, the role of spirometry in COPD diagnosis, monitoring and management also gains significance. COPD is a silent condition, developing and falling under the radar usually only after a considerable and irreversible loss of lung capacity has monitoring those already diagnosed with the condition, can ensure that the correct treatment plans are devised for patients and that the loss in quality of life is minimized.
What is COPD?
COPD can be defined as a limitation of airflow through the airways and lungs. Whereas in asthma attacks bronchodilators are used to combat the rapid narrowing of the airways and help symptoms subside, the symptoms of COPD cannot be fully reversed. This makes it critical to correctly diagnose and continually track disease progression in COPD so that medical measures can be taken to prevent the condition from worsening.
Who is at risk of COPD?
COPD has been found to be strongly correlated with individuals who smoke or have smoked in the past, those who have had prolonged exposure to harmful irritants or pollutants or people who have a family history of COPD, including alpha-antitrypsin deficiency related COPD. Prolonged coughing (with or without sputum), wheezing and shortness of breath may be some physical manifestations of COPD, however, symptoms alone are not reliable indicators and many COPD patients are commonly misdiagnosed with asthma, the flu or a cold. The diagnostic test for COPD is spirometry.
What is spirometry?
Spirometry is a relatively simple and non-invasive test that measures a patient’s lung health values. The basic principle on which modern spirometers operate is to detect how fast and hard you can empty the air in your lungs from a position of full inhalation (lungs completely filled with air). Spirometric indices can help both diagnosed COPD and also identify which of the four stages of COPD a patient has.
Role of spirometry in COPD diagnosis?
There are specific spirometric values used in COPD diagnosis and classification: FEV1 (forced expiratory volume measured in the first second of blowing), FEV6 (forced expiratory volume measured after blowing for 6 seconds or more) and FVC (forced vital capacity or the total amount of air exhaled in one breath). These values and several other factors including patient age must all be considered in combination when diagnosing and categorizing COPD. International guidelines, however, still consider COPD diagnosis as a FEV1/FVC <0.7 after bronchodilator and FEV1 (mild ≥80% predicted, moderate 50-80%, severe 30-49% predicted, very severe <30% predicted). Furthermore, the expiratory flow-volume curve should also be analyzed, as recommended by the ATS/ERS, as the degree of concavity of this curve is a specific and sensitive indicator for small airways disease that may go undetected with FEV1 and FVC considerations alone.
Spirometers for COPD management
Whilst the accuracy and reliability of spirometry results depend on correct exhalation manouvres and patient compliance, the accuracy, reliability, durability and usability of the spirometer itself is also paramount. Ultrasonic sensor technologies, such as those utilized in Spirohome spirometers, are currently state-of-the-art. The user-friendly display of spirometric values and also flow-volume curves, such as those displayed on the Spirohome App interfaces, puts doctors in the best position to draw correct conclusions about a patient’s lung health. Furthermore, a personal spirometer for home-use by the patient, such as the Spirohome Personal, simplifies and streamlines COPD monitoring so that lung values can be consistently collected and shared with a healthcare provider, giving patients and doctors control over COPD management.
- November marks National COPD Awareness Month!
- How is COPD Diagnosed?
- Diagnosis and early detection of COPD using spirometry
- Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary.