How spirometry can help manage COPD

Spirometry can help manage COPD in many different ways. Not only is it the gold standard for making a diagnosis, but it can also assist patients in keeping the disease under control or improving pulmonary function. In this article, we will be explaining how and why spirometry is a valuable ally in coping with COPD.

1. What is COPD?

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. It can be due to different conditions, with emphysema and chronic bronchitis being the most common.

In the case of emphysema, the alveoli – tiny air sacks at the end of the bronchioles – are severely damaged or destroyed, while chronic bronchitis is an inflammation of the lining of the bronchial tubes, which carry air to and from lungs.

Regardless of the underlying cause, COPD can make breathing extremely difficult, with symptoms including shortness of breath, cough, mucus production, dyspnea and wheezing. It can also increase the risk of developing lung cancer or other severe conditions.

1. What is spirometry?

Spirometry is a common and easy-to-perform pulmonary function test that measures how much air a patient is able to breath. It is used to diagnose and monitor COPD as well as other lung diseases such as asthma, cystic fibrosis or pulmonary fibrosis. COPD patients are usually unable to blow out as much air – or as quickly as – people with healthy lungs.

1. Using spirometry to diagnose COPD

No need to explain how a correct diagnosis is key for defining the right treatment plans in patients with chronic conditions. Spirometry is the current gold standard for the diagnosis of COPD, and is usually performed to confirm clinical diagnosis.

The test will measure the following parameters:

• FEV1, i.e. how much air a patient is able to breathe out in 1 second.
• FVC, or forced vital capacity, i.e. how much air a patent is able to breathe out in a single breath.
• FEV1/FVC ratio. If FEV1 is disproportionately lower than FVC, that means that the air cannot flow easily through the lungs. In healthy patients, this ratio should not be inferior to 0.70.

Other parameters that can be measured include lung volume and DLCO (diffusing capacity of the lung for carbon monoxide). DLCO measures how easily carbon monoxide molecules transfer from the alveoli to the hemoglobin of red blood cells, which can be harder in patients with emphysema, due to the loss of surface available for diffusion.

1. Using spirometry to monitor COPD

Patients diagnosed with COPD may be asked to perform a spirometry test from time to time, in order to keep track of lung function and help identifying problems and complications as soon as they arise.

Spirometry can help manage COPD thanks to the wide range of intuitive and easy-to-use devices available for testing and data collection, with no need of hospitalization or in-office visits. This allows patients to set up a daily routine to keep track of their health status, becoming more aware and consistent in following their treatment plans. We explored the advantages of spirometry in monitoring COPD and collecting data in a previous article.

1. Using incentive spirometry to improve lung function in COPD

It is also possible to use spirometry to exercise your lungs, with the use of specific devices named incentive spirometers. Incentive spirometers are usually used after surgery or injury to help patients expand their lungs in order to prevent infections, clear mucus and achieve a normal oxygen level.

Yet, a study conducted on 40 patients diagnosed with COPD – results were published in January 2023 on the Egyptian Journal of Bronchology – showed how incentive spirometry for a short duration helped to improve some respiratory functions, as well as blood gases and diaphragmatic functions, suggesting that it may be a valuable supplemental therapy in COPD management programs.