What are pulmonary function tests (PFTs)?

Pulmonary function tests (PFTs) are a group of tests that measure how well your lungs work. This
includes how well you’re able to breathe and how effective your lungs are able to bring oxygen to the
rest of your body.

Your doctor may order these tests:

 if you’re having symptoms of lung problems

 if you’re regularly exposed to certain substances in the environment or workplace
 to monitor the course of chronic lung disease, such as asthma or chronic obstructive
pulmonary disease (COPD)
 to assess how well your lungs are working before you have surgery

PFTs are also known as lung function tests.

Why are these tests done?

Your doctor will order these tests to determine how your lungs are working. If you already have a
condition 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.

PFTs can help diagnose:

 asthma
 allergies
 chronic bronchitis
 respiratory infections
 lung fibrosis
 bronchiectasis, a condition in which the airways in the lungs stretch and widen
 COPD, which used to be called emphysema
 asbestosis, a condition caused by exposure to asbestos
 sarcoidosis, an inflammation of your lungs, liver, lymph nodes, eyes, skin, or other tissues
 scleroderma, a disease that affects your connective tissue
 pulmonary tumor
 lung cancer
  weaknesses of the chest wall muscles

How do I prepare for pulmonary function

tests?
If you’re on medications that open your airways, such as those used for asthma or
chronic bronchitis, your doctor may ask you to stop taking them before the test. If it isn’t clear
whether or not you should take your medication, make sure to ask your doctor. Pain medications
may also affect the results of the test. You should tell your doctor about any over-the-counter and
prescription pain medications you’re taking.

It’s important that you don’t eat a large meal before testing. A full stomach can prevent your lungs
from inhaling fully. You should also avoid food and drinks that contain caffeine, such as chocolate,
coffee, and tea, before your test. Caffeine can cause your airways to be more open which could
affect the results of your test. You should also avoid smoking at least an hour before the test, as well
as strenuous exercise before the test.

Be sure to wear loose-fitting clothing to the test. Tighter clothing may restrict your breathing. You
should also avoid wearing jewelry that might affect your breathing. If you wear dentures, wear them
to the test to ensure that your mouth can fit tightly around the mouthpiece used for the test.

If you have had recent eye, chest, or abdominal surgery or a recent heart attack, you will likely need
to delay the testTrusted Source until you have fully recovered.

How the Test is Performed

Spirometry measures airflow. By measuring how much air you exhale, and how quickly you
exhale, spirometry can evaluate a broad range of lung diseases. In a spirometry test, while you
are sitting, you breathe into a mouthpiece that is connected to an instrument called a spirometer.
The spirometer records the amount and the rate of air that you breathe in and out over a period of
time. When standing, some numbers might be slightly different.

For some of the test measurements, you can breathe normally and quietly. Other tests require
forced inhalation or exhalation after a deep breath. Sometimes, you will be asked to inhale a
different gas or a medicine to see how it changes your test results.

Lung volume measurement can be done in two ways:

 The most accurate way is called body plethysmography. You sit in a

clear airtight box that looks like a phone booth. The technologist asks you to
 breathe in and out of a mouthpiece. Changes in pressure inside the box help
determine the lung volume.

 Lung volume can also be measured when you breathe nitrogen or

helium gas through a tube for a certain period of time. The concentration of
the gas in a chamber attached to the tube is measured to estimate the lung
volume.

To measure diffusion capacity, you breathe a harmless gas, called a tracer gas, for a very short
time, often for only one breath. The concentration of the gas in the air you breathe out is
measured. The difference in the amount of gas inhaled and exhaled measures how effectively gas
travels from the lungs into the blood. This test allows the health care provider to estimate how
well the lungs move oxygen from the air into the bloodstream.
How to Prepare for the Test
Do not eat a heavy meal before the test. Do not smoke for 4 to 6 hours before the test. You will
get specific instructions if you need to stop using bronchodilators or other inhaled medicines.
You may have to breathe in medicine before or during the test.

How the Test will Feel

Since the test involves some forced breathing and rapid breathing, you may have some
temporary shortness of breath or lightheadedness. You also might have some coughing. You
breathe through a tight-fitting mouthpiece and you will have nose clips. If you are
claustrophobic, the part of the test in the booth may feel uncomfortable.

Follow instructions for using the mouthpiece of the spirometer. A poor seal around the
mouthpiece may cause results that aren't accurate.

Why the Test is Performed

Pulmonary function tests are done to:

 Diagnose certain types of lung disease, such as asthma, bronchitis,

and emphysema
 Find the cause of shortness of breath
 Measure whether exposure to chemicals at work affects lung function

 Check lung function before someone has surgery

 Assess the effect of medicines

 Measure progress in disease treatment

 Measure the response to treatment in cardiopulmonary vascular
disease

Normal Results
Normal values are based on your age, height, ethnicity, and gender. Normal results are expressed
as a percentage. A value is usually considered abnormal if it is approximately less than 80% of
your predicted value.

Normal value ranges may vary slightly among different laboratories, based on slightly different
ways to determine normal values. Talk to your provider about the meaning of your specific test
results.

Different measurements that may be found on your report after pulmonary function tests include:

 Diffusion capacity to carbon monoxide (DLCO)

 Expiratory reserve volume (ERV)

 Forced vital capacity (FVC)

 Forced expiratory volume in 1 second (FEV1)

 Forced expiratory flow 25% to 75% (FEF25-75)

 Functional residual capacity (FRC)

 Maximum voluntary ventilation (MVV)

 Residual volume (RV)

 Peak expiratory flow (PEF)

 Slow vital capacity (SVC)

 Total lung capacity (TLC)

What Abnormal Results Mean

Abnormal results usually mean that you may have chest or lung disease.

Some lung diseases (such as emphysema, asthma, chronic bronchitis, and infections) can make
the lungs contain too much air and take longer to empty. These lung diseases are called
obstructive lung disorders.

Other lung diseases make the lungs scarred and smaller so that they contain too little air and are
poor at transferring oxygen into the blood. Examples of these types of illnesses include:
 Extreme overweight

 Pulmonary fibrosis (scarring or thickening of the lung tissue)

 Sarcoidosis and scleroderma
Muscular weakness can also cause abnormal test results, even if the lungs are normal, that is
similar to the diseases that cause smaller lungs.

Risks
There is a small risk of collapsed lung (pneumothorax) in people with a certain type of lung
disease. The test should not be given to a person who has experienced a recent heart attack, has
certain other types of heart disease, or has had a recent collapsed lung.

Spirometry
This is one of the most common pulmonary function tests. Spirometry measures how much air
you can breathe in and out. It also measures how fast you can empty the air out of your lungs.
Spirometry helps diagnose breathing problems such as asthma and COPD. If you’re taking
an asthma medicine, spirometry can help your doctor learn how well the medicine is working.
During the test, you’ll breathe in as much air as you can. Then you’ll quickly blow as much air
out as you can through a tube connected to a machine called a spirometer.
The test measures two things:
1. The most air you can breathe out after inhaling deeply. The results will let you know if
you have a reduced ability to breathe normally.
2. How much air you can exhale in 1 second. The score tells your doctor how severe your
breathing problem is.

Body Plethysmography
You’ll breathe in deeply for body plethysmography, which measures how much air is in your
lungs when you inhale deeply. It also checks how much air remains in your lungs after you
breathe out as much as you can.
Plethysmography is used for several reasons:

 Your doctor might order this test to see how a disease such as COPD or asthma affects
your lungs. The test may show that your treatment needs to change.
 It can help confirm whether you have a lung disease that reduces the amount of space in
your lungs. Your doctor might call this a restrictive disease.
  It can show if your airways have narrowed. If so, the test may help your doctor decide
whether lung medications called bronchodilators could help you. Bronchodilators open
airways.
 It can help your doctor figure out how well you’d do if you needed surgery.

The test is painless and takes about 15 minutes. During plethysmography, you sit in a clear
plastic box. You wear a nose clip and breathe through your mouth in and out of a special
mouthpiece.

Lung Diffusion Capacity

A lung diffusion capacity test measures how well oxygen moves from your lungs into
your blood.
This test is similar to spirometry. You breathe into a tube attached to a machine. The test can
help diagnose a disease of the blood vessels between your heart and lungs and show the amount
of damage done by a disease such as emphysema, a disease in which your air sacs are gradually
destroyed.

Bronchial Provocation Test

If you have asthma, you know that triggers such as exercise, smoke, and dust can suddenly make
breathing difficult. A bronchial provocation test can help diagnose asthma. Your doctor can also
use it to help measure how severe your asthma is.
During the test, you inhale a medication that makes your airways narrow. Then you take a
spirometry test. You do this several times. Your doctor will use the readings to learn how much
your airways narrow during an asthma attack.

Cardiopulmonary Exercise Stress Test

This test measures lung and heart strength. It’s usually given to people who may have heart
disease or lung problems. Sometimes these conditions show up only during exercise.
During the test, you walk on a treadmill or a ride a stationary bicycle. The doctor keeps an eye
on your heart rate as your heart beats faster and faster. You’ll breathe into a tube that measures
your lungs as they work harder.

Pulse Oximetry Test

This painless test measures how much oxygen is in your blood. The doctor clips a probe to your
finger, your earlobe, or another part of your skin. The device uses light to measure the level of
oxygen in your red blood cells.

Arterial Blood Gas Test

This test measures the levels of gases like oxygen and carbon dioxide in blood taken from one of
your arteries.
You’ll typically go to a hospital or your doctor’s office for an arterial blood gas test. A nurse or
technician will use a needle to take the blood, probably from your wrist. It might hurt, and you
could bleed a bit where the needle went in

Fractional Exhaled Nitric Oxide Test

When you have certain kinds of asthma, you might have high levels of a gas called nitric oxide
in your body. The fractional exhaled nitric oxide test measures how much of it is in the air you
breathe out.
For this test, you breathe out slowly and steadily into a tube that’s connected to a portable
device.

How Do I Get Ready for Pulmonary Function

Tests?
 Take your medications before your test unless your doctor tells you not to.
 Don’t smoke before the test; ask your doctor how long before the test you should stop.
 If you use a short-acting inhaler, try not to use it for 6 to 8 hours before the test. If you do
have to use it, let your doctor know before the test.

PFT Risks and Benefits

Pulmonary function tests are usually safe. You can go back to your normal activities afterward.
Most tests take 15 to 30 minutes.
If you’ve noticed that you’re short of breath, ask your doctor about having a lung function test
soon.
Lung function tests are important, whether you’ve already been diagnosed with a breathing
problem or you think you may have one. They can be the first step toward breathing easier.