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By Jess Kingston posted 11-23-2011 15:16

  
What criteria do you all currently use to proceed from a simple spirometry to a post bronchodialator spirometry?
We currently use a FVC/FEV1 less than 80% for that decision, but am aware that the GOLD Standards are anything less than 70%.
Any of you using this percentage??
Thanks

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12-30-2011 03:35

From Gregg Ruppel's book The Manual Of Pulmonary Function, Ninth Edition, Chapter 2, page 65.
"Even if the FEV1 and FEV1% are normal, one may still test for a bronchodilator response in patients for whom there is a high clinical suspicion of airflow obstruction because the normal range is defined for a population, not for any one individual." My thought's, many times a patient can be wheezing with predicted normals well above 80%. Give the bronchodilator! The stethescope is a pulmonary function tool use it. These patient's can have a significant response to BD.

12-19-2011 10:26

Ours is the FEV1 is below 75%. Then we give brochodilators.

11-23-2011 18:10

Hi Jess! Where I work, the criteria we use is FEV1/FVC is 70% or less in order to move to a post bronchodilator test, but we use the FEV1 as the main indicator to determine if there should be a post bronchodilator test done. Although your institution is correct also. According to the Kettering Study Guide, an indication for a post bronchodilator test would be indicated if FEV1 is below 80%. The FEV1 is the best indicator to determine if airway disease is reversible or not.
I hope this was helpful for you! Good luck